肝硬化CT分型与其并发症关系的研究

目的 探讨肝硬化的CT分型与临床之间的关系。 方法 对357例肝硬化的CT表现进行分型。分析各型肝硬化的脾脏增大、侧枝静脉曲张、腹水、胸腔积液、原发性肝癌、胆囊结石、血常规和肾功能等情况。 结果 357例肝硬化中均匀型87例(占24.4％)、节段型41例(占11.5％)和结节型229例(占64.1％)。节段型和结节型患者,重度脾肿大者分别为29.3％和20.5％,均匀型为8.0％,x~2值分别为10.26和17.95,P值均<0.01。侧枝静脉曲张出现率以节段型最高(70.7％),其次为结节型(17.0％)和均匀型(2.3％),x~2=53.22～12.11,P<0.001。有腹水者结节型182例(79.5％),节段型11例(16.8％),均匀型9例(10.3％),x~2值分别为126.0和47.28,P值均<0.001。原发性肝癌结节型患者中为68例(29.7％),节段型1例(2.4％),均匀型5例(5.7％),x~2值分别为20.35和13.58,P<0.001。结节型血红蛋白降低例数显著多于均匀型,x~2=10.83,P<0.001。节段型和结节型患者的血红蛋白含量均数和血小板数均数均显著低于均匀型,t值分别为1.99、2.04和2.10、2.23,P值均<0.05。节段型和结节型患者血清尿素氮浓度升高例数显著多于均匀型,x~2值分别为10.30和8.51,P值均<0.005,结节型患者的血清尿素氮浓度显著高于均匀型,t=2.52,P=0.0029。结论 CT的肝硬化分型与肝硬化并发症之

A study on relationship between CT grouping and complication of liver cirrhosis

Objective To probe into the relationship between the CT grouping of liver cirrhosis and its complications as well as clinical condition. Methods On the basis of CT findings in 357 cases with liver cirrhosis, CT grouping of the cirrhosis was performed. The complications of the cirrhosis, including enlargement of spleen, varicose collateral veins, ascites, pleurorrhea, primary liver carcinoma, gallbladder stone, etc, of all groups were analyzed. According to examination the blood routine, and the serum urea nitrogen(SUN), creatinine and uric acid, the condition of spleen function accentuation and liver-kidney syndrome were estimated. Results Three hundred and fifty-seven cases with cirrhosis were divided into homogeneous group(87 cases, 24.4%), segmental group(41 cases, 11.5%)and nodal group (229 cases, 64.1%). The grade of spleen enlargement in the segmental group and the nodal group was significantly greater than that in homogeneous group(P<0.01 and 0.001). The cases with varicose in the segmental group was the most (70.7%), in the nodal group next(17.0%) and in the homogeneous group the least(2.3%). There was significant difference among three groups(P<0.001). In the nodal group, there was ascites in 182 cases(79.5%) and significantly more than that in the segmental group(11 cases, 26.8%) and the homogeneous group(9 cases, 10.3%) (P<0.001), and the former significantly more than the latter (P<0.025). There were 68 cases(29.7%) with primary liver carcinoma in the nodal group, and significantly more than that in the segmental group(1 case, 2.4%) and the homogeneous group (5 cases, 5.7%) (P<0.001). The cases with hemoglobin decrease in the nodal group were significantly more than that in the homogeneous group(P<0.001). The averages of hemoglobin and platelet in the nodal group and the segmental group were significantly lower than that in the homogeneous group(P<0.05). The cases with SUN increase in the nodal group and the segmental group were significantly more than that in the homogeneous group(P<0.005). The concentration of SUN in the nodal group was significantly higher than that in the homogeneous group(P=0.0029). Conclusions There are close relationship between the grouping of liver cirrhosis on basis of CT findings and complications of the cirrhosis. The practice of grouping might be useful for estimating clinical condition.