肝硬化早期诊断指标探讨

目的：探讨测量肝血流灌注量对早期诊断肝硬化、判断肝硬化程度的临床价值。材料与方法：以确诊的３０例肝硬化患者为观察组，８例肝脏健康者为对照组，用９９ｍＴｃ体内标记法标记红细胞，以ＳＰＥＣＴ做动态扫描获取图像数据，比较两个组的Ｔｍａｘ、Ｔ１／２、Ｋ值和ＨＰＱ。结果：９０％（２７／３０例）观察对象的ＨＰＱ较对照组的减少地非常显著（Ｐ＜０．０１）；其余指标均有统计学意义（Ｐ＜０．０１）；１０％（３／３０例）观察对象有门脉高压症，ＨＰＱ和Ｋ值高于对照组。结论：肝血流灌注量可以作为肝硬化早期诊断的一个指标；ＨＰＱ和Ｋ值降低与肝功能损伤程度相关，门脉高压症除外；了解门脉高压症时的肝血液动力学数据对合理选用降压药物有临床指导意义。

A Study on Early Diagnosis Criteria of Hepatic Cirrhosis

Purpose: The change of the hepatic blood perfusion quantity (HPQ) may be one of the clinical manifestations of hepatic cirrhosis. So determination of HPQ has clinical value for studying on early diagnosis criteria and determining the degree of hepatic cirrhosis. Materials and Methods: 30 cases who had been diagnosed hepatic cirrhosis entered into study group and 8 cases whose liver function were normal entered into contral group. These patient's T max , T 1/2 , K, HPQ determined by 99m Tc RBC and SPECT dynamic scanning. Results: The results showed that the levels of HPQ in 90% (27/30) patients with hepatic cirrhosis were decreased significantly (P<0.01). There were significant defference of other items between the study group and control group (P<0.01). 10% (3/30)patients with hepatic cirrhosis had portal hypertension and their HPQ and K value were higher than control group. Conclusion: HPQ may be one of the early diagnosis criteria. The lower degree of HPQ and K value was parallel to the degree of cirrhosis. The drugs which decreas portal vein pressure could be accurately seleted based on the value of HPQ with portal hypertension.