彩色多普勒超声检测肝硬化患者门、脾静脉血流动力学的临床意义

摘要

目的 探讨彩色多普勒超声检测肝硬化患者门、脾静脉血流动力学的临床意义.方法 以2013年6月至2016年7月在陕西省渭南市中医医院就诊的80例肝硬化患者为观察组,另选陕西省渭南市中医医院健康体检者50例为对照组.所有研究对象均行腹部彩色多普勒超声检查,分析观察组不同肝损伤程度及食管静脉曲张程度患者的门、脾静脉血流动力学差异,以及肝损伤程度及食管静脉曲张程度与门、脾静脉血流动力学指标的相关性.结果 观察组的Dpv、Ipv、Dsv和Isv均显著高于对照组(P＜0.05),Vpv和Vsv均显著低于对照组(P＜ 0.05);Child-Pauh C级患者的Dpv、Ipv、Dsv、Isv均显著高于A级和B级患者(P＜0.05),Vpv、Vsv显著低于A级和B级患者(P＜0.05);合并中度和重度食管胃底静脉曲张患者的Vpv和Ipv均显著高于无合并食管静脉曲张的患者(P＜0.05),其他指标各组间比较,差异均无统计学意义(P＞0.05);不同程度食管静脉曲张患者的Dsv、Vsv、Isv组间比较,差异均有统计学意义(P＜0.05);Dpv、Ipv、Dsv、Isv与肝功能分级呈正相关(r=0.621、0.731、0.592、0.725,P均＜0.05),Vpv、Vsv与肝功能分级呈负相关(r=-0.655、-0.625,P均＜0.05).Dpv、Ipv、Dsv、Isv与食管静脉曲张程度呈正相关(r=0.429、0.532、0.721、0.740,P均＜0.05),Vpv、Vsv与食管静脉曲张程度呈负相关(r=-0.410、-0.752,P均＜0.05).结论 彩色多普勒超声测量门、脾静脉的血流动力学指标可间接反映肝损伤程度、是否合并食管胃底静脉曲张及曲张的严重程度.%Objective To investigate the clinical significance of color Doppler ultrasonography in the hemodynamics of portal and splenic vein in patients with cirrhosis.Methods From June 2013 to July 2016,80 cases patients with cirrhosis from Chinese Medicine Hospital of Weinan City as the study objects (observation group),50 cases health check-up in same hospital as control group.All objects were accepted abdominal color doppler ultrasonic detection,hemodynamic differences of portal and splenic vein in patients with different degree of liver injury and degree of esophageal varices were analyzed,and the correlation between the degree of hepatic injury and the degree of esophageal varices and the portal vein and splenic vein hemodynamics was examined.Results Dpv、Ipv、Dsv and Isv of observation group were significantly lower than that of control group (P ＜ 0.05),and Vpv and Vsv of observation group were significantly lower than that of control group(P ＜ 0.05);Dpv 、Ipv 、Dsv and Isv of patients with Child-Pauh class C were significantly higher than that of class A and class B (P ＜ 0.05),Vpv and Vsv were significantly lower than class A and class B (P ＜ 0.05).Vpv and Ipv in patients with moderate and severe gastroesophageal varices were significantly higher than those without esophageal varices (P ＜ 0.05).Dpv,Ipv,Dsv and Isv were positively correlated with liver function classification (r =0.621,0.731,0.592,0.725,P ＜ 0.05),while Vpv 、Vsv were negatively correlated with liver function classification (r =-0.655,-0.625,P ＜ 0.05).Dpv、Ipv、Dsv、Isv we re positively correlated with esophageal varices degree (r =0.429,0.532,0.721,0.740,P ＜ 0.05),while Vpv and Vsv were negatively correlated with esophageal varices degree (r =-0.410,-0.752,P ＜ 0.05).Conclusion Color Doppler ultrasound for detecting hemodynamics of portal and splenic vein can indirectly reflect the degree of liver injury and whether to merge esophageal gastric varices and the severity of varicose.