彩色多普勒超声检查对乙型肝炎肝硬化患者食管静脉曲张预测价值分析

目的 探讨使用彩色多普勒超声检查门静脉血流动力学指标预测乙型肝炎肝硬化患者食管静脉曲张的价值。方法 我院收治的乙型肝炎肝硬化患者75例和健康体检者25例,接受胃镜和彩色多普勒超声检查。结果 经胃镜检查,发现静脉曲张56例和无静脉曲张19例;存在静脉曲张和无静脉曲张患者门静脉血管内径分别为（13.7±3.2） mm和（12.1±3.2） mm,显著大于对照组（10.9±3.0） mm,P<0.05],门静脉血流速度分别为（9.3±2.1） cm/s和（13.6±2.7） cm/s,显著慢于对照组（17.7±2.4） cm/s,P<0.05],门静脉血流量分别为（1054.3±336.8） ml/min和（921.6±327.5） ml/min,显著大于对照组（832.5±234.1） ml/min,P<0.05];食管静脉曲张患者胃左静脉离肝血流发生率为80.4%,显著高于无静脉曲张患者的0.0%（P<0.05）;以门静脉血流量等于1000 ml/min为截断点,其判断存在食管静脉曲张的敏感性为78.6%,特异性为79.0%,阳性预测值为91.7%,阴性预测值为55.6%。结论 使用彩色多普勒超声检查门静脉血流动力学指标对肝硬化患者存在食管静脉曲张具有一定的预测价值,而发现胃左静脉离肝血流提示肝硬化患者存在食管静脉曲张的风险较大。

Diagnostic value of color Doppler ultrasound in predicting esophageal varices in patients with hepatitis B-induced liver cirrhosis

Objectiv The aim of this study was to investigate the diagnostic value of color Doppler ultrasound in predicting esophageal varices （EV） in patients with hepatitis B-induced liver cirrhosis （LC）. Methods Seventy-five patients with hepatitis B-induced LC and twenty-five healthy individuals were recruited in this study and all of them underwent gastroscopy and color Doppler ultrasonography to calculate the portal hemodynamic parameters. Results 56 patients with LC were found having and 19 having not EV in our series by gastroscopy; the diameters of portal veins in patients with and without EV were （13.7±3.2） mm and （12.1±3.2） mm,significantly larger than （10.9±3.0）mm,P<0.05] in the control,the portal vein blood flow velocities were （9.3±2.1） cm/s and （13.6±2.7） cm/s,respectively,significantly slower than（17.7±2.4） cm/s,P<0.05] in the control,and the portal vein blood flow volume were（1054.3±336.8） ml/min and（921.6±327.5） ml/min,respectively,significantly higher than （832.5±234.1） ml/min,P<0.05] in the control;the incidence of reverse hepatic blood flow in left gastric vein in patients with EV was 80.4%,significantly higher than 0.0%（P<0.05） in patients without;the sensitivity was 78.6%,the specificity was 79.0%,the positive predictive value was 91.7% and the negative predictive value was 55.6% when the portal vein blood flow volume equal to 1000 ml/min as the cut-off-value in predicting the existence of EV. Conclusion The check-up of hemodynamics index of portal vein by color Doppler ultrasound might help predict the existence and degrees of EV in patients with hepatitis B-induced LC,which warrants further investigation.