高频超声下的胆囊壁厚度与肝硬化失代偿患者门静脉系统血流动力学改变的相关性研究

The relationship between the high frequency ultrasound results of gallbladder wall thickening and the hemodynamic changes of portal vein system in patients with cirrhosis

目的:探讨高频超声下的胆囊壁厚度与肝硬化失代偿患者门静脉系统血流动力学改变的关系。方法:回顾性分析2014年4月至2016年6月期间就诊于我院的肝硬化失代偿期患者64名,根据高频超声的检查结果,将患者分为胆囊不厚组、胆囊单纯增厚组、胆囊双边增厚组。并选取同期24名健康志愿者作为对照组。对比4组患者的门静脉主干血流速度(Vpv)、门静脉主干内径(Dpv)、门静脉主干血流量(Qpv)以及门静脉右支血流速度(Vrpv)、门静脉右支内径(Drpv)、门静脉右支血流量(Qrpv)等指标。并对胆囊壁增厚的高频超声结果与门静脉系统血流动力学改变进行相关性分析。结果:经高频超声检测,4组人员的胆囊壁厚度差异具有统计学意义(P<0.05);4组人员的Vpv、Dpv、Qpv之间均具有差异,差异具有统计学意义(P<0.05);4组人员之间的Drpv及Qrpv差异无统计学意义(P>0.05),仅Vrpv在组间有差异,差异具有统计学意义(P<0.05);前3组与对照组人员Qrpv/Qpv比值差异无统计学意义(P>0.05);Dpv与胆囊壁增厚程度呈正相关(r=0.942,P<0.05),Vpv和Qpv与胆囊壁厚度均呈负相关(r=-0.831,r=-0.927,P均<0.05)。胆囊壁厚度与Drpv、Vrpv及Qrpv之间无相关性(P>0.05)。结论:通过高频超声检测的胆囊壁增厚程度与肝硬化失代偿患者门静脉主干的血流动力学改变息息相关,而与门静脉右支的血流改变无关。

Objective：To investigate the relationship between the high frequency ultrasound resuhs of gallbladder wall thickening and the hemodynamic changes of portal vein system in patients with cirrhosis, so as to provide reference opinions on clinical diagnosis and treatment. Methods：A retrospective analysis from April 2014 ~ June 2016 in our hospital for treatment of patients with decompensated liver cirrhosis in 64, according to the high frequency ultrasound examination results, the patients were divided into groups：gallbladder thickness, simple gall- bladder thickening group, bilateral gallbladder thickening group. And selected 24 healthy volunteers as control group. Compared 4 groups of patients with portal vein blood flow velocity （Vpv）, main portal vein diameter （Dpv）, portal vein blood flow （Qpv） and right portal vein blood flow velocity （ Vrpv）, right portal vein diameter （ Drpv）, right portal vein blood flow （Qrpv） and other indicators. The results of uhra- sonography of gallbladder wall thickening and portal vein hemodynamics change phase Correlation analysis. Results ：The high frequency ultra- sound detection, with significant differences in the thickness of gallbladder wall in the patients of the 4 groups （ P 〈 0.05 ） ; The difference of Vpv, Dpv and Qpv were statistically significant amoung 4 groups of patients （P 〈 0.05） ; While, Drpv and Qrpv were not statistically signifi- cant （P 〉 0.05 ） , only Vrpv was statistically significant （ P 〈 0.05 ） ; There was no significant difference in the ratio of Qrpv/Qpv between the study group and the control group （ P 〉 0.05 ） ; Dpv was positively correlated with the degree of gallbladder wall thickening （ r = 0.942, P 〈0.05 ）, Vpv and Qpv were negatively correlated with gallbladder wall thickness （ r = - 0. 831, r = - 0. 927, P 〈 0.05 ）. There were no correlation between Vrpv , Qrpv, Drpv and the thickness of gallbladder wall （ P 〉 0. 05 ）. Conclusion： The high frequency ultrasound of gall-bladder wall thickening and the hemodynamic changes of portal vein system in patients with cirrhosis are closely related, and the right branch of portal vein blond flow change Change has nothing tn do.