肝动脉血流的特异性改变对肝硬化的预防与治疗作用

目的：探讨肝硬化患者肝动脉血流的特异性改变与肝功能Child—Pugh分级的相关性。方法：120例肝硬化患者根据病因分为两组，A组为60例乙肝病毒型肝硬化（VLC）患者，B组为60例酒精性肝硬化（ALC）患者。另选取60例来我院体检的健康者作为C组。通过彩色多普勒技术检查3组肝固有动脉和门静脉主干的血流参数，计算血流灌注指数（DPI），分析相关参数与肝功能Child—Pugh分级的相关性。结果：相比C组，A、B两组的门静脉主干内径（Dpv）、肝固有动脉内径（DHA）增宽，最大血流速度（Vmax）降低；阻力指数（RI）、搏动指数（PI）均高于c组，差异具有统计学意义（P〈0．05）。A组和B组间血流动力学变化因病因的不同也有较大差异，A组Qpv降低，血流量（QHA）则呈代偿性增高；而B组QHA、Qpv总体均呈下降趋势，A组收缩期峰值流速（PSV）、时间平均流速（TAVMHA）明显高于B组，差异具有统计学意义（P〈0．05）；两组RI、PI相比，差异无统计学意义（P〉0．05）。肝硬化患者肝固有动脉血流速度、QHA随Child—Pugh肝功能分级的加重逐渐增大，与之呈正相关；门静脉的Vmax、QpV随Child—pugh肝功能分级的加重逐渐减少，与之呈负相关；其DPI与Child—Pugh肝功能分级呈正相关。A组、B组与Child—Pugh肝功能分级的相关系数（r值）分别为：0．73、0．70（P=0．000）。结论：肝硬化患者肝动脉血流与Child—Pugh肝功能分级有较好的相关性，可以为临床诊断提供依据，对不同病因所致肝硬化肝硬化的预防和治疗具有重要作用。

Preventive and therapeutic effects of specificity changes in hepatic arterial flow on liver cir- rhosis

Objective： To investigate the correlation between the specificity changes of hepatic arte- rim flow and the Child-Pugh grade in patients with cirrhosis. Methods： A total of 120 patients with cirrho- sis were divided into 2 groups according to different etiological factor. Sixty patients with liver cirrhosis （VLC） caused by hepatitis B virus were defined as group A , the other 60 patients with alcoholic cirrhosis were defined as group B. 60 healthy people were selected as group C （control group）. The hemodynamic parameters of hepatic artery and portal vein were examined by color Doppler flow imaging technique. Then the Doppler perfusion index （DPI） was calculated and the correlation between hemodynamic parameter and the Child-Pugh grade was analyzed. Results： Compare to group C, the Dpv, DHA were widen in group A and group B. The flow rate of Vm,x was decreased, and Qpv was decreased too. RI and PI were higher than those in group C （P all 〈0.05）. The hemodynamic changes showed significant difference with differ- ent etiological factor in group A and group B. Qpv was decreased and QHA was compensated increased in group A, while QHA was globally decreased in group B. The level of PSV, TAVMHA was significant higher in group A than those in group B （all P 〈0.05）. There was no significant difference in RI and PI between group A and group B. PSV, QHA were gradually increased and the V Qpv were gradually decreased with the increasing of Child-Pugh grade in patients with LC. There was positive correlation be- tween the DPI and the Child-Pugh grade, and the r value was 0.73 in group A and 0.70 in group B （P= 0. 000）. Oonclusion： There is good correlation between the specificity changes of hepatic arterial flow and the Child-Pugh grade in patients with cirrhosis. It could be a judgment factor in the diagnosis of LC, and it has important value in preventing and treating LC.