非酒精性脂肪肝患者肝静脉血流多普勒频谱形态的观测

Doppler waveforms of hepatic vein in patients with non-alcoholic fatty liver

目的观测非酒精性脂肪肝肝静脉血流频谱形态的变化情况。方法多普勒超声检测病例组138例非酒精性脂肪肝患者(弥漫性脂肪肝97例,局灶性脂肪肝41例)与对照组91例正常人肝静脉多普勒频谱。病例组所有患者均经超声检查及CT检查诊断脂肪肝,血脂增高,无长期大量饮酒史。对照组经超声及CT检查诊断无脂肪肝,血脂正常。根据多普勒频谱特点将肝静脉波形分为正常型、衰减型、平坦型。结果病例组异常肝静脉波形(衰减型与平坦型)所占比例(59%)较对照组(7%)显著增加,差异有显著性意义(P<0.05),异常肝静脉波形中衰减型(59%)与平坦型(41%)所占比例差异无显著性意义(P>0.05)。弥漫性脂肪肝异常肝静脉波形比例(69%)高于局灶性脂肪肝(37%),差异有显著性意义(P<0.05)。结论脂肪肝患者肝静脉血流频谱可出现异常衰减型、异常平坦型,对脂肪肝肝血流动力学的进一步研究有助于提高对此疾病的诊断、治疗。

Objective To observe changes of hepatic vein Doppler waveforms in patients with non-alcoholic fatty liver. Methods Doppler waveforms of hepatic vein in 138 patients with non-alcoholic fatty liver （97 patients with diffuse fatty liver and 41 patients with focal fatty liver） and 91 normal healthy adults were studied retrospectively, all patients had hyperlipidemia, no history of alcohol drinking and confirmed by US and CT while the subject in control group had normal level in serum lipid. The waveforms of hepatic vein were classified into three patterns., normal, damped, and flatted. Results The proportion of abnormal Doppler waveforms in patients with fatty liver （59 %） were significant higher than those in control group （7%）（P〈0.05）, and significant higher in diffuse fatty liver （69%） group than those focal fatty liver （37%）（P〈0.05）. There were no differences between damped （59%） and flatted （41%）（P〈0.05）. Conclusion The Doppler waveforms pattern of hepatic vein in patients with fatty liver had high incidence of abnormal including damped or flatted.