肝硬化患者门脉系统血流动力学指标与Child-Pugh分级的相关性研究

研究肝硬化患者脾静脉和门静脉血流量及其比值(Qsv/QPv)与肝脏储备功能Child-Pugh分级的关系.采用彩色多普勒超声仪对168例肝炎后肝硬化患者(ChildA级43例,B级67例,C级58例)和59例健康成年人检测了门静脉、脾静脉的内径、流速,再计算出相关的血流量,并进行了比较分析.结果显示,随着Qsv/Qpv的升高,肝硬化患者的肝功能不断下降,各组之间比较有非常显著性差异(P＜0.01).肝硬化患者肝功能损害越重,脾静脉血流量占门静脉血流量的比值越高.如果将Qsv/Qpv的截断值定于40%,则其提示肝硬化患者肝功能下降至B级或以下的敏感性、特异性、准确性分别达80.80%、74.42%和79.17%.彩色多普勒超声测量门静脉系统及其血流动力学指标用于判断肝硬化患者的肝功能状态是一个较好的临床手段.

Correlative study between hemodynamics of portal vein system and Child- Pugh in patients with cirrhosis

To study the the characterisitcs of blood flow on splenic vein(SV) and portal vein(PV) and the correlation with Child-Pugh. There were 168 cases of hepatic cirrhosis. The liver function was graded Child-Pugh A in 43 cases, Child-Pugh B in 67 cases and Child-Pugh C in 58 cases. The inner-diameter and blood stream speed of the splenic vein and the portal vein were measured by the color Doppler ultrasonography. The blood flow volume were calculated. Fifty-nine healty people served as controls in this study. When the proportion of the blood flow volume between SV and PV (Qsv/Qpv) increased, the liver function on patients with hepatocitrrhosis descended gradually. There were very significant difference in all study groups (P<0.01). When the best cut-off value of the Qsv/Qpv was 40%, the diagnostic sensitivity, specificity and accuracy rate to the decay to Child-Pugh B or down of liver function with hepatic cirrhosis were 80.80%,74.42% and 79.17%,respectively. The color Doppler ultrasonography is a very significative clinical means in the judgment of liver function situation on patients with hepatocirrhosis.