肝豆状核变性肝硬化门静脉血流动力学改变与Child-Pugh分级的关系

目的探讨肝豆状核变性（HLD）肝硬化患者门静脉血流动力学的改变及其与Child-Pugh分级的关系,探寻HLD肝硬化程度与门静脉血流动力学的动态变化的关系。方法回顾性分析利用彩色多普勒超声测量57例HLD肝硬化患者于空腹静息状态下门静脉内径（Dpv）和脾静脉内径（Dspv）、门静脉血流速度（Vpv）、脾静脉血流速度（Vspv）,计算门静脉血流量（Qpv）、脾静脉血流量（Qspv）,同时进行肝功能检查,并以50例健康者为对照组。结果①HLD肝硬化组门静脉内径、脾静脉内径明显增宽、血流速度明显减慢,脾静脉血流量增加,肝功能损害越严重,变化越明显。②门静脉血流量在Child A、B级组比正常人增加,而在ChildC级组比正常人减少。结论 HLD肝硬化患者肝脏损害程度不同,门静脉血流动力学变化程度不同,彩色多普勒超声测量HLD肝硬化门静脉血流动力学变化可了解病情严重程度,有助于预后的判断。

The relationship of hemodynamics of the portal system and liver function of Child-Pugh classification in patients with hepatocirhosis of hepatic lenticular disease

Objective To study the relationship of hemodynamics of portal system and liver function of Child-Pugh classification in patients with hepatocirhosis of HLD.Methods Color doppler flow imaging was used to measure the inner diameters of portal vein and splenic vein,the velocity of blood flow of portal vein and splenic vein in 57 patients with hepatocirhosis of HLD,and the quantity of flow of portal vein and splenic vein were calculated,which were compared with in 50 healthy control.Results ①In patients with hepatocirhosis of HLD,the inner diameter of portal vein and splenic vein were widened,the velocity of blood flow of portal vein and splenic vein were slowed down and the quantity of blood flow of splenic vein was increased,and the worse the damage of liver function was,the more obvious the change became.②In patients with Child-Pugh A and B,the quantity of blood flow of portal vein was increased,and in patients with Child-Pugh C,the quantity of blood flow of portal vein was increased decreased.Conclusion The change in hemodynamics of portal system varies with the damage in liver function in patients with hepatocirhosis of HLD.Measuring the hemodynamics of portal system can provide useful information in assessing the severity of the disease and the prognosis.