自体骨髓干细胞移植术后门静脉血流动力学的变化

Study of hemodynamic changes in portal venous flow after autologous bone marrow stem cell transplantation

目的观察肝硬化自体骨髓于细胞移植术后门静脉血流动力学的变化。方法应用彩色多普勒超声测量50例自体骨髓干细胞移植术后患者门静脉血流动力学的变化，术前～术后半年进行定期随访。记录患者门静脉内径、门静脉平均血流速度及脾脏厚度，比较自体骨髓干细胞移植前后三者的变化。结果（1）术后各时段门静脉内径分别为（1．41±0．15）cm、（1．38±0．11）cm和（1．36±0．17）cm，与术前（1．53±0．18）cm比较明显减小，差异有显著性（P〈0．05），但术后各时段之间比较差异无显著性（P〉0．01）；（2）术后各时段门静脉血流速度值分别为（15．7±3．6）cm／s、（16．1±2．4）cm/s和（15．9±3．0）cm／s，与术前（11．4±3．3）cm／s比较明显增加，差异有显著性（P〈0．01），但术后各时段之间比较差异无显著性（P〉0．01）；（3）术后各时段脾脏厚度分别为（4．8±0．3）cm、（4．7±0．6）cm和（4．8±0．5）cm，与术前（5．2±0．7）cm比较明显缩小，差异有显著性（P〈0．01），但术后各时段之间比较差异无显著性（P〉0．01）。结论自体骨髓干细胞移植术可有效增加门静脉血流速度，并使脾脏缩小，从而降低门静脉压力，减轻门静脉高压。

Objective To study hemodynamic changes in portal venous flow after autologous bone marrow stem cell transplantation. Methods The effect of autologons bone marrow stem cell transplantation on portal venous hemodynamics was recorded by color Doppler sonography in 50 patients who were followed up for 6 months. Sonographic arameters such as portal vein diameter, portal blood flow mean velocity and spleen size were compared before and after autologous marrow stem cell transplantation. Results （1）After autologous marrow stem cell transplantation,portal vein was（ 1.41 ±＋ 0.15 ）cm, （1.38 ± 0.11 ）cm, （1.36 ± 0. 17 ）cm, respectively. They were significantly reduced compared with preoperation （ 1.53 ± 0.18 ） cm （ P 〈 0.05 ） ; but there were no difference among them （ P 〉 0.01 ）. （2） Portal blood flow mean velocity was （ 15.7 ±3.6 ） cm/s, （ 16.1 ± 2.4 ） cm/s, （ 15.9 ± 3.0 ） cm/s, respectively they were significantly increased compared with preoperation（ 11.4 ± 3.3 ） cm/s（ P 〈 0.01 ） ; but there were no difference among them（P 〉 0.01 ）. （3） Spleen size was （4.8 ± 0.3 ） cm, （4. 7 ± 0.6） cm, （4.8 ± 0.5 ） cm, respectively they were significantly decreased compared with preoperation （ 5.2 ± 0.7 ） cm （ P 〈 0.01 ） ; but there were no difference among them （P 〉 0.01 ）. Conclusions Autologous bone marrow stem cell transplantation can effectively increase the portal vein blood flow, and to shrink the spleen, thus portal pressure and portal hypertension were reduced.