彩色多普勒超声评估肝硬化门静脉高压症患者肝脏血流动力变化及其与肝脏储备功能的相关性  

Relationship between hepatic hemodynamic changes assessed by color Doppler ultrasound and liver reserve function in cirrhotic patients with portal hypertension

作　　者：刘建军 周琳 章志 Liu Jian-jun;Zhou Lin;Zhang Zhi(Department of Ultrasound,People's Hospital,Nancheng General Hospital,Fuzhou 344700,Jiangxi,China)

机构地区：[1]南城县总医院人民医院院区超声科,江西抚州344700

出　　处：《四川生理科学杂志》2024年第12期2761-2763,共3页

摘　　要：目的:彩色多普勒超声评估肝硬化门静脉高压症(Portal hypertension,PHT)患者肝脏血流动力学变化及其与肝脏储备功能的相关性分析。方法:选取2020年1月至2023年12月我院诊治的62例肝硬化PHT患者作为观察组,按Child-Pugh评分将其分为A级(n=20)、B级(n=24)和C三级(n=18);并选取同期健康体检者60例为对照组,彩色多普勒超声检测肝脏血流动力[门静脉主干内径(Diameter of portal vein,DPV)、门静脉最大血流速度(Maximum blood flow velocity in portal vein,PVX)、门静脉平均血流速度(Average portal vein velocity,PVM)、门静脉血流量(Quantity of blood flow in portal vein,QPV)],全自动生化分析仪检测肝储备功能[谷丙转氨酶(Alanine transaminase,ALT)、谷草转氨酶(Aspartate transaminase,AST)、总胆红素(Total bilirubin,TBIL)、白蛋白(Albumin,ALB)、凝血酶原时间(Prothrombin time,PT)],分析肝硬化PHT患者血流动力学与肝储备功能的关系。结果:观察组DPV、QPV和AST、ALT、ALB、PT高于对照组,PVX、PVM和TBIL低于对照组(P<0.05)。观察组肝功能C级患者DPV、QPV和AST、ALT、ALB、PT高于肝功能A级、B级患者,PVX、PVM和TBIL低于肝功能A级、B级患者,肝功能B级患者DPV、QPV和AST、ALT、ALB、PT高于肝功能A级患者,PVX、PVM和TBIL低于肝功能A级患者(P<0.05)。Pearson相关分析显示,肝硬化PHT患者DPV、QPV与AST、ALT、ALB、PT呈正相关,与TBIL呈负相关;PVX、PVM与AST、ALT、ALB、PT呈负相关,与TBIL呈正相关(P<0.05)。结论:肝硬化PHT患者肝脏血流速度减慢、门静脉内径增大、血流量增多,且与肝脏储备功能密切相关,可有效判断患者病情程度。Objective:To analyze the relationship between hepatic hemodynamic changes assessed by color Doppler ultrasound and liver reserve function in cirrhotic patients with portal hypertension(PHT).Methods:62 patients with PHT from cirrhosis diagnosed and treated from January 2020 to December 2023 were selected as the observation group,and divided into grade A(n=41),grade B(n=52)and grade C(n=25)according to Child-Pugh score.At the same time,60 healthy individuals were selected as the normal control group.Color Doppler ultrasound was used to detect hepatic hemodynamics[diameter of portal vein(DPV),maximum blood flow velocity in portal vein(PVX),average portal vein velocity(PVM)and quantity of blood flow in portal vein(QPV)],and automatic biochemical analyzer was used to detect liver reserve function[alanine transaminase(ALT),aspartate transaminase(AST),total bilirubin(TBIL),albumin(ALB)and prothrombin time(PT)].The correlation between hemodynamic indexes and liver reserve function indexes was analyzed by Pearson method.Results:DPV,QPV,AST,ALT,ALB and PT in observation group were higher than those in control group,PVX,PVM and TBIL in observation group were lower than those in control group(P<0.05).In the observation group,DPV,QPV,AST,ALT,ALB,and PT in grade C were higher than those in grade A and B,PVX,PVM,and TBIL in grade C were lower than those in grade A and B,and DPV,QPV,AST,ALT,ALB,and PT in grade B were higher than those in grade A.PVX,PVM and TBIL in group B were lower than those in grade A(P<0.05).Pearson correlation analysis showed that DPV and QPV were positively correlated with AST,ALT,ALB and PT,and negatively correlated with TBIL in patients with cirrhotic PHT.PVX and PVM were negatively correlated with AST,ALT,ALB and PT,and positively correlated with TBIL(P<0.05).Conclusion:The hepatic blood flow velocity is relatively low,and the diameter of portal vein and blood flow are increased in patients with cirrhotic PHT,which is closely related to liver reserve function.These indexes can help to determine the pat

关 键 词：肝硬化 门静脉高压症 彩色多普勒超声 肝脏血流动力 肝脏储备功能 

分 类 号：R575.2[医药卫生—消化系统]