肝硬化门静脉血流动力学改变与肝功能状况的关系

PORTAL HEMODYNAMICS STUDIED BY COLOR DOPPLER ULTRASONOGRAPHY IN PATIENTS WITH DIFFERENT CLASSIFICATIONS OF CIRRHOSIS

目的 :观察肝硬化患者门静脉血流动力学的改变及其与肝功能Child -Pugh分级的关系。方法 :对 31例肝硬化患者于空腹静息状态下取仰卧位应用彩色多普勒超声检测门静脉直径、流速及门静脉血流量。结果 :肝硬化组的门静脉直径增宽 (1.46± 0 .2 1vs 1.0 8± 0 .12 )cm (P <0 .0 1) ,血流速度显著低于正常对照组(16 .43± 7.33vs 2 5 .5 0± 8.31)cm/s(P <0 .0 1) ,门静脉血流量无显著性改变。Child -PughC级患者门静脉流速及门静脉血流量明显低于A级、B级。结论 :肝硬化患者门静脉直径增宽 ,血流速度显著下降 ;而且门静脉流速及门静脉血流量随肝功能恶化而明显下降。因此 ,动态观测上述指标对判断肝功能状态及预后有重要临床意义。

Objective:To observe the Changes of portal hemodynamics in cirrhotic patients with Color Doppler ultrasonography and to study the relationship between portal Hemodynamics and the Child-Pugh classification.Methods:We studied potal hemodynamical parameters in thirtyone portal-hypertensive cirrhotic patients with Color Doppler ultrasonography.Results:The diameters of portal vein were higher in cirrhotic patients than those of normal control(1.46±0.21 vs 1.08±0.12cm,P<0.01) while their flow velocity was lower (16.43±7.33 vs 25.50±8.31cm/s,P<0.01).And there was no difference in portal blood flow volume in cirrhotic patients as compared to controls.Comparisons of the portal flow velocity and blood flow volume in group of patients with dfferent liver function were shown as follows:Child-PughC<Child-PughB and Child-PughA.Conclusions:Portal flow significantly decreased in cirrhotic patients with worsening Child-Pugh classification of cirrhosis.