超声评估下肢静脉曲张与下腔静脉血流参数的相关性

Evaluation of the correlation between varicose veins of the lower extremity and the bloodflow parameters of inferior vena cava by ultrasonography

目的探讨超声评估下肢静脉曲张临床-病因-解剖-病理生理学(clinical etiology anatomy pathophysiology,CEAP)临床分级与下腔静脉血流参数的相关性。方法随机选取下肢静脉曲张患者109例为病例组。以CEAP临床分级为标准,按照是否有静脉曲张所致皮肤病变分为A组(C1~C3级)57例、B组(C4~C6级)52例。另选择同期与病例组相匹配的健康体检者27例为对照组(C组)。记录所有受试者性别、年龄、身高、体重,计算体表面积、体重指数(body mass index,BMI)。应用超声取下腔静脉(inferior vena cava,IVC)下段横切面测量长径、短径、周长,计算横截面积;纵切面测量最高流速,计算血流量。结果3组性别、年龄、身高差异无统计学意义(P>0.05)。A组、C组体重、体表面积、BMI均低于B组,差异有统计学意义(P<0.05);A组与C组体重、体表面积、BMI差异无统计学意义(P>0.05)。A组、B组IVC长径、周长大于C组,差异有统计学意义(P<0.05);A组与B组IVC长径、周长差异无统计学意义(P>0.05)。B组血流量大于C组,差异有统计学意义(P<0.05),A组血流量与B组、C组差异无统计学意义(P>0.05)。3组间IVC短径、面积、最高流速差异无统计学意义(P<0.05)。CEAP临床分级与体质量、体表面积、BMI呈正相关(P<0.05);与性别、年龄、身高无相关性(P>0.05)。CEAP临床分级与IVC长径、周长、血流量呈正相关(P<0.05);与IVC短径、横截面积、最高流速无相关性(P>0.05)。结论下肢静脉曲张发生与体重、体表面积和BMI有关。CEAP临床分级早期IVC形态发生改变,以横切面长径、周长增大显著,而血流量增加发生在有皮肤病变的更高临床分级。

Objective To explore the correlation between the clinical classification of clinical etiology anatomy pathophysiology(CEAP)of varicose veins of the lower extremity and the blood flow parameters of inferior vena cava(IVC)evaluated by ultrasonography.Methods A total of 109 patients with varicose veins of the lower extremity were randomly selected as case group.According to the clinical classification of CEAP and skin lesions caused by varicose veins,the cases were divided into group A(classes C1 to C3,n=57)and group B(classes C4 to C6,n=52).And 27 matched healthy subjects during the same period were selected as the control group(group C).The gender,age,height,and body weight were recorded,and the body surface area and body mass index(BMI)of all the cases were calculated.Using Ultrasonography,the long and short diameter,circumference and cross sectional area were measured on the transversal plane of lower segment of the IVC.The maximum velocity and flow volume of IVC were calculated on its longitudinal section.Results There was no significant difference in gender,age and height among the three groups(P>0.05).The body weight,body surface area and BMI of group A and group C were obviously lower than those of group B(P<0.05),whereas the differences of the above parameters between group A and group C were not statistically different(P>0.05).In group A and B,the long diameter,circumference of IVC were remarkably larger than those of group C(P<0.05),while there was no significant difference between group A and B(all P>0.05).The flow volume of IVC in group B was higher than that in group C(P<0.05),while compared with groups B and C,no significant difference was found in group A(P>0.05).There were no markedly difference in short diameter,cross sectional area and the maximum velocity of IVC among the three groups(P>0.05).The clinical classification of CEAP was positively correlated with the body weight,body surface area and BMI(P<0.05),but not correlated with gender,age and height(P>0.05).And it was positively correlated with the long diameter,circumference and flow volume of IVC(P<0.05),but was not correlated with short diameter,cross sectional area and the maximum velocity(P>0.05).Conclusion Varicose vein of lower extremity is related to body weight,body surface area and BMI.In the early stage of CEAP clinical classification,the morphology of IVC is changed,specifically long diameter and circumference of transverse section that are increased obviously,while the blood flow volume is increased significantly in the higher grade with skin lesions.