无创伤法联合测定门静脉压力及肝血流评价肝硬化疗效

Estimating Treatment Effect for Hepatic Cirrhosis Patients by Method Combining Testing Liver Blood Flow with ~(99)Tc~m-RBC and Portal Vein Pressure with ~(99)Tc~m-MIBI

目的 为临床评价肝硬化疗效提供有价值的手段。方法 采用99Tcm-RBC及99Tcm-MIBI分别测定 16例肝硬化患者治疗前后的肝血流及门静脉压力。前者选择峰时 (T(max) 、半廊清时 (T1/ 2 )、廊清率 (K值 )及肝血流(LBF)等作为观察指标 ;后者以心 /肝 (H/L)比值及门静脉压力 (PVP)为观察指标。结果 治疗前Tmax、T1/ 2 、K值及LBF分别为 1.83± 1.0 4min、5 .3 7± 2 .19min、0 .10± 0 .0 3及 0 .45± 0 .16L/min ,而治疗后分别为 0 .86± 0 .2 0min、3 .80± 1.86min、0 .14± 0 .0 4及 0 .64± 0 .2 0L/min ,治疗前后各项指标均有非常显著性差异 (P <0 .0 1或 0 .0 0 1)。服药前H/L、PVP分别为 0 .73± 0 .16及 3 .0 0± 0 .5 5kPa;治疗后分别为 0 .47± 0 .18及 2 .2 0± 0 .62kPa,与治疗前相比均有非常显著性差异 (均P <0 .0 0 1)。结论 所用测定肝血流及门静脉压力的两种方法均无创伤性 。

Objective To provide important method for estimating treatment effect of hepatic cirrhosis in practical medical work.Methods In 16 patients with hepatic cirrhosis liver blood flow (LBF) and port vein pressure (PVP) were tested in pre-and post-treatment groups with 99Tc m-RBC and 99Tc m-MIBI respectively.Peak time (T max),semi-time(T 1/2),clearance rate(K) and LBF were regarded as indications of the experimental observation for testing LBF.And they were compared with indications pre-and post-treatment groups.PVP in 16 patients were determined with the method of 99Tc m-MIBI via rectum and ratio of radioactivity in heart to live (H/L) was used as shunt index.Results T max,T 1/2,K and LBF of 16 hepatic cirrhosis patients pre-treatment were 1.83±1.04 min,5.37±2.19 min,0.10±0.03 and 0.45±0.16 L/min respectively;and post-treatment were 0.86±0.20 min,3.80±1.86 min,0.14±0.04 and 0.64±0.20 L/min respectively.There were very remarkable differences (P<0.01 or P<0.001) in relevant indications of pre- and post-treatment.H/L and PVP in 16 hepatic cirrhosis patients were 0.73±0.16 and 3.00± 0.55 kPa pre-treatment;and were 0.47±0.18 and 2.20±0.62 kPa post-treatment respectively.There were very remarkable differences (P<0.001) in relevant individuals of pre- and post-treatment.Conclusion Two methods are not only convenient,but also untramatic.They are able to be used in estimating treatment effect in hepatic cirrhosis patients.