肝硬化门静脉高压门脉血流动力学检测及其临床意义

Clinical significance examining the portal system hemodynamics of portal hypertension in patients with cirrhosis by color Doppler ultrasound

目的 探讨肝硬化门脉高压患者门脉血流动力学状态并分析其与Child Pugh肝功能分级的关系。方法 利用多普勒超声技术检测了 10 0例肝硬化门脉高压患者及 2 4例正常人门脉血流动力学状态 ,并将 10 0例肝硬化门脉高压患者按Child Pugh肝功能分级分析两者之间的关系。结果 肝硬化门脉高压门脉血流动力学检测与正常对照组比较 ,门脉高压组门静脉 (PV)内径明显增宽、血流速明显减慢、血流量参数明显增加 ,差异有显著性意义 ( P <0 .0 1) ;脾静脉 (SV )、肠系膜上静脉 (SMV)内径 (D)、血流速度(V)、血流量参数 (Q)也有类似改变。A、B、C三级肝硬化的PV内径 ,按A、B、C顺序显示门静脉宽度逐渐增宽 ,C级的Dpv较A、B级均有显著性增宽 (P <0 .0 5 ) ,A、B级间差异无显著性意义 (P >0 .0 5 ) ,但B级较A级也有增宽趋势。按A、B、C顺序显示门静脉血流速度逐渐降低 ,且各级间比较差异有显著性意义(P <0 .0 5 )。A、B、C级的Qpv相互比较无统计学差异 (P >0 .0 5 )。结论 多普勒超声检测门脉血流动力学有助于评价肝硬化患者的肝储备功能、门静脉高压程度及预后。

Objective To examinate the portal system hemodynamics of portal hypertension in patients with cirrhosis and analysis the relationship between the changes of the portal system hemodynamics and the Child Pugh grade.Methods The portal system hemodynamics of portal hypertension were examined in 100 patients with cirrhosis and 24 normal subjects used color Doppler ultrasound and 100 cirrhosis patients were graded by the Child Pugh grade.Results There were significant changes in the portal system hemodynamics of portal hypertension between cirrhosis and 24 normal subjects,the diameter of the portal vein(D pv ),the splenic vein(D sv ) and the superior mesenteric vein(D smv ), the speed of the portal vein(V pv ),the splenic vein(V sv ) and the superior mesenteric vein(V smv ) ,the flow of the portal vein(Q pv ),the splenic vein(Q sv ) and the superior mesenteric vein(Q smv ) were significantly increased (P< 0.01 ),respectively.The D pv of Child grade C patients were wider than the those of Child grade A and B patients(P< 0.05 ), the V pv of Child grade C patients had more decrease than the those of Child grade A and B patients(P< 0.05 ), but Q pv was were no significant difference between Child grade A,B and C groups patients(P> 0.05 ). Conclusions Examination of the portal system hemodynamics of portal hypertension in patients with cirrhosis can be used to evaluate the degree of liver function and the portal hypertension in cirrhosis patients.