彩色多普勒超声分析肝硬化合并门静脉血栓患者肝、脾动脉阻抗指数

Color Doppler ultrasonographic analysis on the impedance indices of hepatic and splenic artery in liver cirrhosis patients with portal vein thrombosis

目的观察肝硬化合并门静脉血栓时肝、脾动脉阻抗指数的特点,探讨其产生机制及意义。方法应用彩色多普勒技术分别检测8例肝硬化合并门静脉血栓、16例肝硬化不伴门静脉血栓及16名正常人的门静脉、肝动脉和脾动脉的血流动力学指标,对三组指标进行统计学分析。结果肝硬化合并门静脉血栓组与肝硬化不伴门静脉血栓组比较,门静脉时间平均最大流速(PVTAMV)明显减低(P<0.05),脾动脉阻力指数(SARI)、脾动脉搏动指数(SAPI)、门脉高压指数(PHI)明显增加(P<0.05),而两组的肝动脉阻力指数(HARI)、肝动脉搏动指数(HAPI)比较差异无统计学意义(P>0.05)。肝硬化组的PVTAMV、SARI、SAPI、PHI、HARI、HAPI与正常对照组比较差异均有统计学意义(P<0.05)。结论PVTAMV、SARI、SAPI和PHI可作为反映门静脉高压严重程度的重要指标。

Objective To observe the features of the hepatic and splenic artery impedance indices in liver cirrhosis patients with portal vein thrombosis. Methods Eight cases of liver cirrhosis with portal vein thrombosis, 16 cases of liver cirrhosis without portal vein thrombosis and 16 healthy subjects were detected with color Doppler technology about hemodynamic indicaters of the portal vein, hepatic artery and splenic artery, and these indicaters were comparatively analyzed. Results Time average maximum velocity of portal vein （PVTAMV） in cirrhosis patients with portal vein thrombosis was statistically lower than that in patients without portal vein thrombosis （P〈0.05）, and resistive index of splenic artery （SARI）, pulsatility index of splenic artery （SAPI） and portal hypertension index （PHI） in cirrhosis patients with portal vein thrombosis were statistically higher than those in cirrhosis patients without portal vein thrombosis （P〈0.05）, while resistive index of hepatic artery （HARI） and pulsatility index of hepatic artery （HAPI） of the two groups showed no significant difference （P〉0.05）. PVTAMV, SARI, SAPI, PHI, HARI and HAPI of cirrhosis patients and the controls were all statistically different （P〈0. 05）. Conclusion PVTAMV, SARI, SAPI and PHI can be used as important indicators reflecting the seriousness of portal hypertension.