超声检测肝豆肝病患者肝脾血流及相关性研究

Detection of blood flow dynamic changes of liver and spleen in hepatolenticular degeneration patients by ultrasound

目的通过观察肝豆肝病患者门静脉、肝动脉和脾门处脾动脉、脾静脉血流动力学变化,探讨超声在检测肝豆肝病肝脏、脾脏血流变化中的应用价值。方法体检健康者60例为对照组,肝豆肝病未合并脾大组(A组)60例,肝豆肝病合并脾大组(B组)60例,超声观测其肝动脉、脾门处脾动脉的血流收缩期峰值速度(PSV),门静脉主干及脾静脉最高血流速度(Vmax);分析肝动脉、脾门处脾动脉PSV相关性。结果 1与对照组比较,A组和B组门静脉Vmax均降低,脾门处脾动脉PSV增高,且血流量明显上升;B组肝动脉PSV减低;A组脾门处脾静脉Vmax降低;B组脾门处脾静脉Vmax升高,差异均有统计学意义(P<0.05)。2与A组比较,B组门静脉、脾门处脾静脉Vmax和肝动脉PSV均降低,脾门处脾动脉PSV增高,差异均有统计学意义(均P<0.05)。3肝动脉PSV与脾门处脾动脉PSV呈负相关(r=-0.837,P=0.039)。结论超声监测肝豆肝病患者肝脏、脾脏的血流动力学变化,可为临床早期评估肝脏、脾脏的血流灌注状态,对病情进展及其治疗提供参考。

Objective To observe the hemodynamic changes of portal vein, hepatic artery, splenic artery and vein near the hilus, and to explore the application value of ultrasound in detection of blood flow changes of liver and spleen in hepatolenticular degeneration（HLD） patients. Methods Color Doppler ultrasound was performed in three groups [normal group,HLD without splenomegaly group（group A） and HLD combined with splenomegaly group（group B）]. The maximum velocity（Vmax） of portal vein, the peak systolic velocity（PSV） of hepatic artery, the PSV of splenic artery and the Vmax of vein near the hilus were measured, and the correlation of PSV between the hepatic artery and the splenic artery was analyzed.Results 1Compared with normal group, the Vmax of portal vein and splenic vein in group A and B were reduced, PSV of splenic artery was accelerated. The PSV of hepatic artery was reduced in group B, and these changes were statistically significant（P 0.05）. 2 Compared to group A,the Vmax of portal vein and splenic vein, the PSV of hepatic artery were reduced, PSV of splenic artery was accelerated, and the changes were statistically significant（P 0.05）. 3 The PSV of hepatic artery and splenic artery had negative correlation（r=-0.837, P =0.039）. Conclusion Detection of the hemodynamic changes of liver and spleen in HLD patients by ultrasound can be used to evaluate the blood perfusion of the two organs,which provides certain theory reference for the progress and treatment of the disease.