右心衰肝静脉频谱异常对肝脏弹性模量的影响

Influence of Hepatic Vein Anomaly Caused by Right Heart Failure on Liver Elastic Modulus

目的:探讨右心衰肝静脉频谱(HVS)异常对肝弹性模量(LEM)的影响。方法:随机选取无肝脏自身疾病、临床确诊的48例右心衰患者作为研究组,40例健康成年人志愿者作为健康对照组,利用彩色多普勒超声测量HVS,同时利用实时剪切波弹性成像测量LEM,分析右心衰HVS异常对LEM的影响。结果:(1)健康对照组HVS均呈HV1型,37例LEM检查成功,LEM均值为(6.08±0.85)k Pa;(2)研究组43例检测LEM有效,其中25例HVS呈HV2型,LEM均值为(9.51±1.46)k Pa;18例HVS呈HV3型,LEM均值为(23.93±6.82)k Pa;(3)健康对照组和研究组整体比较采用单因素方差分析(ANOVA),LEM均值差异有统计学意义(F=175.57,P=0.000)。Tamhanes T2检验型间两两比较(HV1型与HV2型、HV1与HV3型、HV2型与HV3型)LEM均值比较,差异有统计学意义(T=-9.14、-11.44、-9.81,P=0.000、0.000、0.000)。结论:右心衰致HVS异常对LEM影响明显,随着HVS分型越高,LEM也逐渐增高,右心衰是影响LEM的一个重要因素。

Objective： To investigate the effect of hepatic vein frequency spectrum （HVS） abnormal- ity caused by right heart failure on hepatic elastic modulus （LEM）. Methods： Forty-eight patients with right heart failure were randomly selected as study group and 40 healthy adult volunteers as control group. The HVS was measured by color Doppler ultrasound and the effect of HVS on LEM was analyzed by real-time shear wave elasticity imaging. Results： （1） HVS in healthy control group was HV1, and LEM of 37 cases were successfully detected, the mean value of LEM was （6. 08 ± 0. 85 ） kPa; （2） LEM of 43cases were successfully detected in the study group, and HVS of 25 cases was HV2, the mean value of LEM was （9.51 ± 1.46） kPa, HVS of 18 cases were HV3, and the mean LEM was （23.93 ±6.82） kPa; （3） There was significant difference of LEM between control group and study group（F = 175.57,P =0. 000）. The difference of LEM between type HV1 and HV2, type HV1 and HV3, type HV2 and HV3 was statistically significant （t = - 9. 14, - 11.44, - 9.81 ; P 〈 0.05 ）. Conclusions： HVS abnormality caused by right heart failure has significant effect on LEM, with the in- crease of HVS score, LEM is gradually increased, and right heart failure is an important factor affect- ing LEM.