摘要
目的探讨肝硬化合并门脉高压(PHT)患者血流动力学与肝储备功能之间的关系,寻找两者对疾病评估的意义。方法选取2016年1月至2018年1月在本院肝病中心诊治的80例肝硬化合并PHT患者为观察组,按照Child评分将其分为A、B、C三级,选取同期健康体检者35例为正常对照组,采用彩色多普勒超声仪检测患者肝脏血流动力学参数,全自动生化分析仪检测肝储备功能项目,采用Pearson法分析血流动力学指标与肝储备功能之间的相关性,采用logistic多元回归分析肝硬化合并PHT的危险因素。结果观察组患者门静脉主干内径(DPV)、门静脉最大血流速度(PVX)、门静脉平均血流速度(PVM)和门静脉血流量(QPV)显著高于对照组(P<0.05),ALB、ALT、AST和凝血酶原时间(PT)显著高于对照组(P<0.05),总胆红素(TBIL)显著低于对照组(P<0.05)。肝功能C级患者的DPV、PVX、PVM和QPV显著高于A级和B级患者(P<0.05);肝功能B级患者的DPV、PVX、PVM和QPV显著高于A级患者(P<0.05)。肝功能C级患者的TBIL显著低于A级和B级患者(P<0.05),ALB、ALT、AST和PT显著高于A级和B级患者(P<0.05);肝功能B级患者的TBIL显著低于A级(P<0.05),ALB、ALT、AST和PT显著高于A级患者(P<0.05)。肝硬化合并PHT患者DPV、PVM、QPV与PT呈正相关(P<0.05),PVM、QPV与TBIL呈负相关(P<0.05)。回归分析结果显示,患者的血流动力学指标DPV、PVX、PVM、QPV与肝储备功能指标TBIL、ALB、ALT、AST、PT均是导致肝硬化门脉高压的危险因素。结论血流动力学与肝储备功能指标在不同程度肝硬化合并门脉高压(PHT)患者中存在一定的规律性,两者关系密切,可作为肝硬化合并门脉高压(PHT)疾病评估和监测的重要项目。
Objective To investigate the relationship between hemodynamics with hepatic reserve function in cirrhosis patients complicated with portal hypertension(PHT),and to explore the significances of the two in evaluating the disease.Methods According to the Child score,80 cirrhosis patients complicated with PHT from January 2016 to January 2018 in our hospital were divided into three grades:A,B and C,35 healthy persons in the same period were selected as normal control group.The parameters of liver hemodynamics were detected by color Doppler ultrasound,and the items of liver reserve function were detected by automatic biochemical analyzer.The correlation between hemodynamic indexes and liver reserve function was analyzed by Pearson method,and the risk factors of liver cirrhosis with PHT were analyzed by logistic multiple regression.Results The diameter of portal inner vein(DPV),maximum speed of blood flow in the portal vein(PVX),mean speed of blood flow in the portal vein(PVM),quantity of blood flow in the main portal vein(QPV),albumin(ALB),cerealthirdtransaminase(ALT),aspartate transaminase(AST)and prothrombin time(PT)in the observation group were significantly higher than those in the control group(P<0.05),while the total bilirubin(TBIL)was significantly lower than that in the control group(P<0.05).The levels of DPV,PVX,PVM and QPV in patients with grade C were significantly higher than those in grade A and grade B(P<0.05);the levels of DPV,PVX,PVM and QPV in patients with grade B of liver function were significantly higher than those in grade A(P<0.05).The level of TBIL in patients with grade C liver function was significantly lower than that in grade A and grade B patients(P<0.05);ALB,ALT,AST and PT were significantly higher than those of grade A and grade B(P<0.05);the level of TBIL in patients with grade B of liver function was significantly lower than that of grade A(P<0.05),while the ALB,ALT,AST and PT were significantly higher than those in group A(P<0.05).DPV,PVM and QPV were significantly positively correlated with PT in cirrhosis patients with and PHT(P<0.05),PVM and QPV were significantly negatively correlated with TBIL(P<0.05).Regression analysis showed that hemodynamic indexes in DPV,PVX,PVM,QPV and liver reserve function indexes TBIL,ALB,ALT,AST,PT were risk factors for portal hypertension in cirrhosis.Conclusions Hemodynamics and hepatic reserve function indicators have certain regularity in different degrees of cirrhosis complicated with PHT patients,they are closely related and can be used as an important index in the evaluation and monitoring of cirrhosis with PHT。
作者
蒋梦真
Jiang Mengzhen(Department of Gastroenterology,the First Affiliated Hospital of Hunan University of Medicine,Huaihua 418000,China)
出处
《中国医师杂志》
CAS
2020年第3期385-389,共5页
Journal of Chinese Physician
关键词
肝硬化
门静脉高压
血流动力学
肝储备功能
Liver cirrhosis
Portal hypertension
Hemodynamics
Hepatic reserve functional
