肝硬化食管静脉曲张破裂出血患者门静脉血流动力学与IGF-I关系的研究

目的　探讨肝硬化食管静脉曲张破裂出血患者的门静脉血流动力学特点及其与血清IGF I的关系。方法　选择肝硬化食管静脉曲张破裂出血患者 2 1例为出血组 ,同期住院的肝硬化非出血患者 17例作为对照组。采用B超和彩色多普勒超声测定门静脉血流动力学的各项参数 ,并作血清IGF I检测。结果　出血组门静脉主干最高血流速度 ,门静脉血主干血流量与对照组相比均有显著差异 (P <0 0 5) ;IGF I出血组与对照组相比无明显差异 (P >0 0 5) ;Q分流量出血组和对照组与IGF I测值相关分析 ,两组均显示负相关。IGF I与食管静脉曲张程度、有无胃静脉曲张及门脉高压性胃病的程度均无明显差异 (P >0 0 5)。结论　彩色多普勒超声监测门静脉主干最高血流速度和每分钟血流量对预测肝硬化食管静脉曲张破裂出血是一项有前景的非创伤性指标 ,IGF I测定对预测门静脉分流情况有一定帮助

THE CORRELATION BETWEEN THE PORTAL VAIN HEMODYNAMIC CHANGES IN CIRRHOTIC PATIENTS WITH ESOPHAGEAL VARICES AND INSULIN-LIKE GROWTH FACTOR IGF-I

Objective: To study the correlation between the portal vain h emodynamic changes in cirrhotic patients with esophageal varices and the serum l evel of insulin-like growth factor IGF-I. Methods: Patients with esophageal varices were divided into two groups: bleeding group (n=21) and nonbleeding group (n=17). The changes of portal venous hemodyna mic parameters were detected through B ultrasound and color Doppler ultrasound. The serum level of IGF-I was measure d by radioimmunoassay. Results: The peak flow velocity in the main portal vein of bleeding group was significantly lower than that of nonbleed ing group. The blood flow in the main portal vein of bleeding group was also sig nificantly lower than that of nonbleeding group(P<0 05). The serum level o f IGF-I wasn′t significantly different in two groups. IGF-I had negative corr elation with shunt flow from the main portal vein in both bleeding group and non bleeding group. The serum level of IGF-I hadn′t obviously difference in patien ts with esophageal varices, gastric varices and portal hypertensive gastropathy. Conclusion: Color Doppler ultrasound proved to be a prospecti ve and noninvasive method to examine the peak flow velocity and the blood flow i n the main portal vein. The serum level of IGF-I had certain value to diagnose and prognosticate the situation of portosystemic shunting.