彩色多普勒超声检查吸毒者门静脉血流动力学的变化

The changes of portal hemodynamics in injection drug addicts by color Doppler ultrasonography

目的研究吸毒者门静脉系统血流动力学的变化及吸毒年限和吸毒方式对肝脏损害的影响。方法根据吸毒年限将213例吸毒者分为吸毒少于1年、1～3年和超过3年组。另选择健康体检者53例作对照。使用彩色多普勒超声（CDFI）检测门静脉左支矢状部（LPV）、门静脉右支（RPV）和脾门处脾静脉（SPV）血流速度（V，cm/s）和管腔内径（D，mm）。结果本组正常人LPV、RPV和SPV内径分别为8.4±1.2mm、8.5±1.2mm和6.1±1.2mm，血流速度分别为19.1±1.8cm/s、19.9±2.7cm/s和17.2±2.5cm/s；吸毒超过3年者两指标分别为9.3±0.9mm（P〈0.01）、9.6±0.8m（P〈0.01）和6.3±0.8mm，和15.2±2.5cm/s（P〈0.01）、16.2±2.2 cm/s（P〈0.01）和14.2±2.4cm/s（P〈0.01），与正常人相差显著；吸毒1-3年者两指标亦有一些变化，而吸毒低于1年者两指标与正常人无显著性差异。结论吸毒年限越长、采用静脉注射吸毒方式和存在的慢性病毒性肝炎反复活动可致吸毒者肝损害严重，最终可能加速了肝纤维化和肝硬化的进程。

Objective To investigate the changes of portal hemodynamics in injection drug addicts by color Doppler ultrasonography. Methods 213 injection drug addicts and 53 healthy persons were recruited in this study,and the drug addicts were divided into less than 1 year,1 to 3 years and longer than 3 years group ac-cording to the drug-taking time. The sagittal part of portal vein （LPV）,right branch of portal vein（RPV）and splenic vein （SPV）were detected for the blood flow velocity and lumen diameter by color Doppler ultrasonography （CDFI）. Results The lumen diameters of LPV,RPV and SPV in normal persons were 8.4±1.2mm,8.5±1.2mm and 6.1±1.2mm,and blood flow velocity were 19.1±1.8cm/s,19.9±2.7cm/s and 17.2±2.5cm/s,respectively;the two parameters in injection drug users having drugs longer than three years were 9.3±0.9mm（P〈0.01）,9.6±0.8mm（P〈0.01） and 6.2±0.8mm,and 15.2±2.5cm/s（P〈0.01）,16.2±2.2 cm/s（P〈0.01）and 14.2±2.4cm/s（P〈0.01）,respectively,signifi-cantly different as compared with those in normal persons;There were some abnormal changes in the two parame-ters in drug users having drugs for one to three years,while there were no significantly differences in drug users having drugs for less than one year as compared with normal persons. Conclusion The findings of CDFI indi-cate that long period of drug use,intravenous injection and the existence of chronic viral hepatitis might damage the liver and accelerates the course of liver fibrosis and liver cirrhosis.