肝静脉血流定量分析与肝纤维化分期关系的研究

The research of relation between quantitive analysis on hepatic venous blood and hepatic fibrosis staging

目的定量分析慢性肝炎患者肝静脉血流最大正向血流速度(Vs)与最大逆向血流速度(Va)之和(△V),探讨其与肝纤维化分期的相关性。方法应用超声检查114例慢性肝炎患者并计算△V,肝纤维化程度均由经超声引导下肝组织活检病理证实,并将△V与肝纤维化分期进行对照分析。结果慢性肝炎肝纤维化血流速度的特征表现为:△V在S0～S3期之间差异无显著性,在S0、S1、S2、S3期分别与S4期之间差异具有统计学意义(P<0.05)。慢性肝炎肝纤维化分期中,△V对S4期的诊断敏感性为73.3%,特异性55.0%。当△V小于30cm/s时,可诊断为早期肝硬化或肝硬化。结论慢性肝炎肝静脉△V的变化,在S0～S3期之间无明显诊断意义,当△V小于30 cm/s时,对S4期的诊断有较高价值;超声检测慢性肝炎患者肝静脉△V,对判断慢性肝炎肝纤维化程度方面有一定的临床价值。

Objective To explore the relation between quantitive analysis on the sum of maximum antrorse and reverse hepatic venous blood flow rate （ΔV） and hepatic fibrosis staging. Methods One hundred and fourteen patients with chronic hepatitis underwent color Doppler ultrasonography and ΔV was calculated, hepatic fibrosis staging were confirmed by ultrasound - guided liver biopsy, and the relation between ΔV and hepatic fibrosis staging were analyzed. Results The blood flow rate characteristics of chronic hepatitis were there was no statistically significant differences when maximum antrorse hepatic venous blood flow rate（Vs） ranged from S0 to S4 and reverse hepatic venous blood flow rate（Va） ranged from S0 to S3; It was zero when Vs ranged from S0 toS3（ 10% - 28% ）and Vs was S4（30% ）.There was no significant differences when ΔV range from S0 to S3. There were significant differences between S0,S1. S2 ,S3 and S4 （P 〈 0.05）. The sensitivity and specificity of ΔV in hepatic cirrhosis staging for S4 was 73.3% ,55.0% respectively. The （early） hepatic cirrhosis could be diagnosed when ΔV was less than 30 cm/s. Conclusion There was no significant differences when AV ranged from S0 to S3. The sensitivity was high when ΔV was less than 30 cm/s. In chronic hepatitis cases, ΔV has clinical value to judge the degree of hepatic fibrosis.