乙肝后肝硬化中医证型与肝脾超声血流动力学参数的相关性研究

Correlation of Liver and Spleen Ultrasonic Hemodynamic Parameters of Post-Hepatitis B Cirrhosis with Different TCM Syndromes

目的探讨乙肝后肝硬化中医证型与肝、脾血流动力学参数的相关性,以发现对其中医辨证有价值的超声检查参考指标。方法对符合乙肝后肝硬化标准的135例患者进行辨证分型和肝脾超声检查。对门静脉内径及平均血流速度、脾静脉内径及平均血流速度、门静脉每分钟血流量、脾静脉每分钟血流量、门静脉淤血指数、脾静脉淤血指数等指标进行检测并分析。结果脾肾阳虚、瘀血阻络证与肝气郁结、湿热内蕴证相比较,门静脉淤血程度更重,具体表现为主干内径更宽、主干血流量更大、血流流速更缓、淤血指数更高等。脾静脉血流动力学参数与中医证型的相关性不甚明显。结论乙肝后肝硬化患者的中医证型分布伴随病情进展呈动态演变的规律。门静脉主干内径、门静脉主干血流量及流速、门静脉淤血指数可以作为脾肾阳虚证、瘀血阻络证的判断参考依据。

Objective To explore and identify the correlation of liver and spleen hemodynamic parameters of cirrhosis after hepatitis B with different TCM syndromes,so as to discover valuable ultrasound parameters on TCM syndrome differentiation.Methods For 135 patients in accordance with hepatitis B cirrhosis standard,standardized TCM syndrome differentiation and laboratory test were executed.Portal vein and splenic vein＇s diameter,blood flow velocity,blood volume per minute and congestion index were measured and analyzed.Results Compared with liver qi stagnation syndrome and damp-heat accumulation syndrome,yang deficiency syndrome of spleen and kidney and blood stasis syndrome appeared more severe portal vein congestion.As the inner diameter of the trunk gradually widened,portal vein blood volume per minute increased gradually and blood flow velocity slow down.Splenic vein hemodynamic parameters showed no significant relationship with TCM syndrome.Conclusion TCM syndrome has a regular pattern of dynamic evolution with the progress of post-hepatitis B cirrhosis.Portal vein＇s diameter,blood flow velocity,blood volume per minute and congestion index may be appropriate as reference on TCM syndrome judgement of yang deficiency syndrome of spleen and kidney and blood stasis syndrome.