常规超声及二维剪切波超声弹性成像技术评价妊娠期高血压疾病患者肝脏硬度的研究  

Conventional ultrasound and two-dimensional shear wave ultrasound elastography for evaluation on liver stiffness in patients with hypertensive disorders of pregnancy

作　　者：张威 张宇虹[1] 王丽霞[2] 刘佳欣 Zhang Wei;Zhang Yuhong;Wang Lixia;Liu Jiaxin(Department of Ultrasound,the Second Hospital of Dalian Medical University,Dalian 116023,China;Department of Obstetrics,the Second Hospital of Dalian Medical University,Dalian 116023,China)

机构地区：[1]大连医科大学附属第二医院超声科,大连116023 [2]大连医科大学附属第二医院产科,大连116023

出　　处：《中国医师进修杂志》2024年第8期699-704,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的应用常规超声及二维剪切波超声弹性成像(2D-SWE)技术评价妊娠期高血压疾病(HDP)患者肝脏硬度改变。方法前瞻性选取2023年5—9月于大连医科大学附属第二医院确诊妊娠的妇女73例。根据HDP诊断标准将其分为妊娠不合并HDP组(A组,36例)及妊娠合并HDP组(B组,37例)。另选取同期36例健康志愿者为健康对照组(C组)。应用二维超声测量肝左叶前后径、上下径、肝右叶最大斜径及门静脉主干内径;应用脉冲频谱多普勒测量门静脉主干血流速度;应用2D-SWE技术测量肝脏硬度,比较各组间的参数差异。结果A组和B组肝右斜径均大于C组[13.87(0.54)cm和13.95(0.36)cm比13.56(1.02)cm],差异有统计学意义(P均<0.01),A组与B组肝右斜径比较差异无统计学意义(P>0.05)。A组、B组肝脏实质的平均杨氏模量值(Emean)均大于C组[5.02(0.62)kPa和5.99(0.31)kPa比4.76(0.08)kPa],差异有统计学意义(P均<0.01),且B组大于A组(P<0.05)。舒张压为Emean的独立影响因素(P<0.05);Emean及舒张压均为HDP的独立影响因素(P均<0.05)。结论利用2D-SWE技术能够准确、客观、无创地评估HDP患者肝脏硬度的异常改变。Objective:To evaluate the abnormal changes in the liver stiffness(LS)in the pregnant women with or without hypertensive disorder of pregnancy(HDP)using conventional ultrasound and two-dimensional shear wave ultrasound elastography(2D-SWE).Methods:A total of 73 pregnant women were enrolled and diagnosed in the Second Affiliated Hospital of Dalian Medical University from May to September 2023.They were divided into pregnant women without HDP(group A,36 cases),and pregnant women with HDP(group B,37 cases).Another 36 healthy volunteers were enrolled in the control group(group C).The thickness and length of the left lobe of the liver,the maximum oblique diameter of the right lobe of the liver and the diameter of the main trunk of the portal vein were measured with two-dimensional ultrasound.The velocity of the portal vein was measured with pulse wave Doppler.2D-SWE technique was used to measure LS(E mean).Parameters were compared among the groups.Results:The right hepatic oblique diameters in groups A and B were larger than those in group C:13.87(0.54)cm and 13.95(0.36)cm vs.13.56(1.02)cm(all P<0.01),but there was no significant difference in the right hepatic oblique diameter between group A and group B(P>0.05).E mean in both group A and group B were greater than those in group C:5.02(0.62)kPa and 5.99(0.31)kPa vs.4.76(0.08)kPa(P<0.01).E mean in group B was greater than that in group A(P<0.05).Systolic and diastolic blood pressure were independent impact factors of Emean(P<0.05).E mean and diastolic blood pressure were independent impact factors of HDP(P<0.05).Conclusions:2D-SWE technique could be used to accurately,objectively and non-invasively evaluate abnormal the changes of liver stiffness in patients with HDP.

关 键 词：超声检查 二维剪切波超声弹性成像技术 妊娠期高血压疾病 肝脏 

分 类 号：R714.246[医药卫生—妇产科学] R445.1[医药卫生—临床医学]