CAJ | 학술논문

目的：探讨应用彩色多普勒超声显像仪以及瞬时弹性成像（FibroScan）观察和分析肝硬化患者的门静脉、肝动脉血流动力学改变的意义。方法选择2010年3月至2013年12月本院收治的乙型肝炎肝硬化患者192例，另选健康人100例，使用彩色超声多普勒显像仪检测门静脉平均血流速度（PVVmean）、肝动脉搏动指数（HAPI）、肝动脉阻力指数（HARI）；同时进行FibroScan检测，检测结果以肝硬度（LSM）表示。计量资料以均数±标准差（x ±s）表示，组间比较采用t检验。结果肝硬化患者HAPI、HARI和LSM分别为1．56±0．24、0．73±0．05和25．38±7．73 kPa，明显高于正常对照组的1．36±0．14、0．65±0．07和7．8±3.6 kPa，t值分别为8.980、10.158、26.478，P值均＜0．05）；而肝硬化患者 PVVmean 为（14．43±1．86）cm/s，明显低于正常对照组（17.35±0.56）cm/s（t＝20.076，P＜0．05）。LSM与肝硬化患者HAPI 和HARI 呈正相关，相关系数r分别为0．59、0．66，P值均＜0．001，与PVVmean呈负相关（r＝－0．64，P＜0．001）。结论利用FibroScan测量肝脏硬度以及彩色多普勒超声动态检测肝硬化门静脉高压患者门静脉、肝动脉血流动力学变化，对判断肝硬化程度具有重要意义。
목적：탐토응용채색다보륵초성현상의이급순시탄성성상（FibroScan）관찰화분석간경화환자적문정맥、간동맥혈류동역학개변적의의。방법선택2010년3월지2013년12월본원수치적을형간염간경화환자192례，령선건강인100례，사용채색초성다보륵현상의검측문정맥평균혈류속도（PVVmean）、간동맥박동지수（HAPI）、간동맥조력지수（HARI）；동시진행FibroScan검측，검측결과이간경도（LSM）표시。계량자료이균수±표준차（x ±s）표시，조간비교채용t검험。결과간경화환자HAPI、HARI화LSM분별위1．56±0．24、0．73±0．05화25．38±7．73 kPa，명현고우정상대조조적1．36±0．14、0．65±0．07화7．8±3.6 kPa，t치분별위8.980、10.158、26.478，P치균＜0．05）；이간경화환자 PVVmean 위（14．43±1．86）cm/s，명현저우정상대조조（17.35±0.56）cm/s（t＝20.076，P＜0．05）。LSM여간경화환자HAPI 화HARI 정정상관，상관계수r분별위0．59、0．66，P치균＜0．001，여PVVmean정부상관（r＝－0．64，P＜0．001）。결론이용FibroScan측량간장경도이급채색다보륵초성동태검측간경화문정맥고압환자문정맥、간동맥혈류동역학변화，대판단간경화정도구유중요의의。
Objective To explore the relationship between hemodynamic changes of the portal vein and hepatic artery measured by color Doppler ultrasound and FibroScan value in patients with liver cirrhosis.Methods A total of 192 patients with hepatitis B cirrhosis who were admitted to our hospital from March 2010 to December 2013,as well as 100 healthy persons,were recruited.The mean portal vein blood flow velocity (PVVmean),hepatic artery pulsatility index (HAPI),and hepatic artery resistance index (HARI)were measured by color Doppler ultrasound.FibroScan was also carried out.All data were statistically analyzed using SPSS 13.0.Continuous data were expressed as mean ±SD and compared between groups by t-test.Results The HAPI,HARI,and FibroScan value of the patient group were 1 .56 ± 0.24,0.73 ±0.05,and 25.38 ±7.73,respectively,significantly higher than those of the control group (1.36 ±0.14,0.65 ±0.07,and 7.8 ±3.6)(P<0.05);the PVVmean of the patient group was 14.43 ±1.86,significantly lower than that of the control group (17.35 ± 0.56)(P<0.05).FibroScan value was positively correlated with HAPI and HARI (r1 =0.59,r2 =0.66,P<0.001),but negatively correlated with PVVmean (r=-0.64,P<0.001).Conclusion The liver stiffness assessed by FibroScan and the hemodynamic changes of the portal vein and hepatic artery measured by color Doppler ultrasound are vitally important for evaluating the severity of liver cirrhosis.