肝炎后肝硬化患者食管静脉曲张程度与门静脉主干内径及Child-Pugh分级的相关性研究

Research on the clinical correlations between the degree of esophageal varices and diameter of main portal vein and Child-Pugh grading in patients with post-hepatitis cirrhosis

目的分析肝炎后肝硬化患者食管静脉曲张(EV)程度与门静脉主干内径及肝功能Child-Push分级的相关性。方法收集68例肝炎后肝硬化患者,行胃镜检查了解EV情况,腹部B型超声测量门静脉主干内径,采用Child-Pugh分级标准进行肝功能分级,分析EV程度与门静脉主干内径、肝功能Child-Push分级的相关性。结果 68例患者中EV程度轻度37例,中度17例,重度14例;肝硬化Child-Pugh分级A级17例,B级28例,C级23例。门静脉主干内径越宽,食管静脉曲张程度越重(r=0.498,P=0.000)。肝功能分级越高,门静脉内径越宽,且食管静脉曲张程度越重(r=0.360,P<0.01),3组间比较,差异均有统计学意义(P<0.05)。EV程度、门静脉主干内径、Child-Pugh分级三者间呈正相关(r=0.498,P=0.000;r=0.360,P=0.003;r=0.230,P=0.049)。结论食管静脉曲张程度与门静脉主干内径、肝功能分级之间具有一定相关性。综合分析可较准确地预测肝硬化严重程度。

Objective To analysis the correlation of esophageal varices （ EV）, diameter of main portal vein and Child- Pugh grade of liver function in patients of post-hepatitis cirrhosis. Methods Sixty eight patients with post-hepatitis cirrhosis, and detected the degree of the EV by gastroscopy, measured their main portal vein diameter with B uhrasonography, used Child-Pugh grading to grade their hepatic function. Then evaluate the correlation among the degree of EV, diameter of main portal vein and the grade of liver function. Results Among 68 cases of EV, there were 37cases of mild degree, 17 cases of moderate degree and 14 cases of severe degree, Child-Pugh grading showed 17 cases of grade A ,28 cases of grade B and 23 cases of grade C. The larger of diameter of main portal vein, the severer of esophagus varix＇s degree （ r = 0. 498, P = 0. 000）. The more worse the grade of liver function, the worse vein diameter the wide, the more severe of esophagus varix ＇s degree （ r = 0. 360, P 〈 0.01 ） , B grade and A grade, C grade and A grade, C grade and B grade comparison, the difference has statistical significance （ P 〈 0.05 ）. EV degree, main portal vein diameter and Child-Pugh grading had positive correlation （ r = 0. 498, P = 0. 000 ; r = 0. 360, P = 0. 003 ; r = 0. 230, P = 0. 049 ） Conclusion There were some extent of correlation between degree of the esophagus varix and diameter of main portal vein, liver function ratings. General analysis could be more accurately predict the severity of liver cirrhosis.