慢性病毒性肝炎G/S分期与脾脏指标的关系

Relation between indexes of spleen and G/S staging in chronic viral hepatitis

目的探讨慢性病毒性肝炎不同G/S分期与脾脏指标的关系。方法361例慢肝患者根据肝穿结果分为无肝纤维化(S0)到肝硬化(S4)五期,按炎症分为Gl～G4四级。对照组104例为体检健康者。比较慢肝组与对照组之间以及慢肝不同G/S分期之间脾脏指标的差异。结果慢肝组与对照组脾脏大小、脾动静脉内径以及脾血流量差异有显著性,且慢肝组均大于对照组;G分期之间脾脏大小、脾静脉内径以及脾动脉最大速度差异有显著性,且随G分期增高而增大;S分期之间脾脏大小、脾静脉内径与流速、脾动脉阻力指数差异有显著性;不同炎症活动度之间脾脏大小、脾静脉内径以及脾动脉最大速度差异有显著性,且随炎症程度越重诸数值越大;脾脏厚度与脾静脉内径及血流量的相关系数分别为0.510、0.447。结论慢肝患者脾脏增大,脾动静脉内径增宽,脾血流量增多,且随G/S分期增高而增高。脾脏大小、脾动静脉内径以及血流动力学指标有助于判断病情。

Objective To discuss the relation between indexes of spleen and G/S staging in chronic viral hepatitis. Methods According to the pathology result of needle biopsy, the liver fibrosis status of 361 chronic viral hepatitis patients was graded as S0-S4 ,and the inflammatory reaction in the liver was graded as G1-G4. The control group consisted of 104 healthy persons. The discrepancy of spleen indexes was compared between the case group and the control group and among G/S stagings. Results The discrepancy of the size of spleen, inside diameter of splenic artery and vein, blood flow of spleen was significant between case group and control group, and these indexes in the case group were higher than those in the control group. The values of the size of spleen, inside diameter of splenic vein and VsSPA increased as the G stagings became high- er, and there was significantly difference. The discrepancy of the size of spleen, inside diameter and velocity of splenic vein, RI of splenic artery was significant among the S stagings. The discrepancy of the size of spleen, inside diameter of splenic vein and VsSPA was significant among the different patient＇s conditions and these indexes increased as the patient＇s condition became graver. The correlation coefficients between the spleen thickness and inside diameter of splenic vein, blood flow of spleen were 0. 510, 0. 447, respectively. Conclusion The size of spleen, the inside diameter of splenic artery and vein, the blood flow of spleen increased in chronic viral hepatitis, and with the G/S stagings increased and higher. The size of spleen, the inside diameters of splenic artery and vein, hemodynamic indexes of spleen are helpful to estimate the patient＇s disease.