超声评价慢性乙型肝炎肝硬化方法的临床研究

Clinical study of ultrasonic evaluation of liver cirrhosis

目的应用二维超声测量非脂肪餐前后胆囊壁厚度及前后径改变,探讨慢性乙型肝炎肝硬化与胆囊壁厚度及前后径改变的关系。方法选取86例不同程度肝硬化患者及40名健康体检者,应用二维超声测量空腹胆囊壁厚度及前后径、餐后1、2 h胆囊壁增厚量及前后径缩短量、门静脉内径、脾脏厚度及腹水量,并分析与肝功能ChildPugh改良法分级的相关性。结果肝硬化空腹胆囊壁增厚与肝功能Child分级呈正相关性,相关度较强(rs=0.724,P=0.000),与餐后1 h胆囊壁增厚量亦具有较好的负相关性,与门静脉、脾肿大及腹水均具有显著相关性(P<0.01)。结论超声为肝硬化分级提供了新方法,空腹胆囊壁厚度及餐后1 h胆囊壁增厚量是评估肝硬化分级指标之一。

Objective To study the relationship between chronic hepatitis B and liver cirrhosis and the changes on the anteroposterior diameter of the gallbladder wall thickness by two-dimensional ultrasound measurement of non-fat fasting.Methods 86 patients with different degree of liver cirrhosis patients and 40 normal controls were selected for the study.Two-dimensional ultrasound was used to measure the gallbladder wall and anteroposterior diameter of the gallbladder wall thickness during fasting,the thicking of gallbladder wall and shortening of anteroposterior diameter of the gallbladder wall at 1 and 2h postprandial,the portal vein width,splenomegaly and ascites.The measurements were correlated to the hepatic function classification determined by the improved Child-Pugh method. Results Fasting gallbladder wall thickening and liver cirrhosis Child-Pugh classification has strong positive correlation（rs=0.724,P=0.000）,and gallbladder wall thickening at 1 postprandial also has a good negative correlation,and the portal vein width,splenomegaly,and ascites have significant positive correlation（P〈0.01）. Conclusions Ultrasound provides a new way of diagnosis of liver cirrhosis,gallbladder wall thickness during fasting and 1h postprandial can be a new index for liver cirrhosis classification.