多普勒超声检测慢性乙型肝炎及肝硬化患者门静脉和脾静脉血流的临床意义

目的评价各型慢性乙型肝炎及肝硬化患者门静脉、脾静脉的血流动力学改变。方法将111例慢性乙型肝炎患者分成轻度组、中度组、重度组及肝硬化组。选取22例健康人为对照组。超声检测门、脾静脉内径及平均流速，计算二者血流量及血流量比值，并行组间比较。结果轻度组与对照组比较，门静脉平均流速（Vpv）、门静脉内径（Dpv）、脾静脉内径（Dsv）无统计学差异（P〉0．05）。中度组的Vpv较对照组、轻度组减慢（P〈0．05）。重度组和肝硬化组的Vpv较轻、中度组及对照组减慢（P〈0．05）。重度组Dpv、Dsv较对照组增大（P〈0．05）。肝硬化组的Dpv、Dsv较其他组增大（P〈0．01）。肝硬化组脾静脉血流量（Qsv）和脾、门静脉流量比值（Qsv／Qpv）较其他组增高（P〈0．01）。结论慢性乙型肝炎及肝硬化患者Vpv、Dpv、Dsv能反应肝脏功能损害程度，Qsv、Qsv／Qpv是反映门静脉压力的较好指标，为慢性乙型肝炎及肝硬化的临床诊断及治疗评价提供了一定帮助。

Clinical significance of portal vein, splenic vein blood flows in patients with chronic hepatitis B and liver cirrhosis by color Doppler ultrasonography

Objective To evaluate the hemodynamic changes of portal vein and splenic vein in patients with chronic hepatitis B and liver cirrhosis. Methods One hundred and eleven patients with chronic hepatitis B were divided into mild group, moderate group, severe group and liver cirrhosis group, and 22 normal people were included in the study as control group. The diameter, average blood flow velocity of portal vein and splenic vein in each group were measured by ultrasound, and the blood flow and blood flow ratio were calculated. Results Compared with control group, there were no significant difference in portal vein average blood flow velocity （Vpv）, portal vein diameter （Dpv） and splenic vein diameter（Dsv） in mild group （ P 〉 0.05）. Vpv of moderate group was slower than that of control group and mild group（ P 〈 0.05） . Vpv of severe group and cirrhosis group were significant slower than that of moderate groups, mild group and control group （ P 〈 0.05）. Dpv and Dsv in severe group were significantly increased than control group（ P 〈 0.05）. Compared with other groups, Dpv and Dsv in cirrhosis group were significantly increased（ P 〈 0.01 ）. Qsv and Qsv/Qpv ratio in cirrhosis group were significantly increased than those in other groups （ P 〈 0.01）. Conclusion Vpv, Dpv and Dsv of patients with chronic hepatitis B and cirrhosis can reflect liver dysfunction degree. Qsv and Qsv / Qpv are good indexes to reflect portal vein pressure, and provide some help for clinical diagnosis and treatment evaluation to chronic hepatitis B and cirrhosis.