CAJ | 학술논문

目的探讨肝段下腔静脉压力对兔肝脏弹性的影响.方法16只新西兰大白兔,开腹后于第二肝门上方结扎下腔静脉,通过静脉内滴注肝素生理盐水溶液使下腔静脉压力逐渐上升至25 cm H2 O(1 cm H2 O=0.098 kPa),然后解除结扎.分别于下腔静脉阻断前、下腔静脉阻断后压力为15、20和25 cm H2 O时及下腔静脉再通5 min后采用剪切波弹性成像技术测定实验动物肝脏弹性值.结果下腔静脉阻断前实验动物肝脏弹性平均值为(7.57±0.99) kPa,下腔静脉阻断后压力为15、20和25 cm H2 O时实验动物肝脏弹性平均值分别为(14.40±0.78)、(18.99±1.22)和(25.73±1.46) kPa,下腔静脉再通5 min后实验动物肝脏弹性平均值为(7.33±0.95) kPa.不同时间点之间肝脏弹性平均值差异有统计学意义(F=686.99,P<0.01).每个时间点肝脏弹性值与后一时间点肝脏弹性值差异均有统计学意义(阻断前vs阻断后下腔静脉压力为15 cm H2 O时,q=22.78,P<0.01;阻断后下腔静脉压力为15 cm H2 O时vs阻断后下腔静脉压力为20 cm H2 O时,q=15.30,P<0.01;阻断后下腔静脉压力为20 cm H2 O时vs阻断后下腔静脉压力为25 cm H2 O时,q=22.50,P<0.01;阻断后下腔静脉压力为25 cm H2 O时vs再通后,q=61.38,P<0.01).肝脏弹性平均值与下腔静脉压力之间呈显著正相关(r=0.943,P<0.01).结论下腔静脉压力升高可提高肝脏弹性值,且与静脉压力呈显著相关.
목적탐토간단하강정맥압력대토간장탄성적영향.방법16지신서란대백토,개복후우제이간문상방결찰하강정맥,통과정맥내적주간소생리염수용액사하강정맥압력축점상승지25 cm H2 O(1 cm H2 O=0.098 kPa),연후해제결찰.분별우하강정맥조단전、하강정맥조단후압력위15、20화25 cm H2 O시급하강정맥재통5 min후채용전절파탄성성상기술측정실험동물간장탄성치.결과하강정맥조단전실험동물간장탄성평균치위(7.57±0.99) kPa,하강정맥조단후압력위15、20화25 cm H2 O시실험동물간장탄성평균치분별위(14.40±0.78)、(18.99±1.22)화(25.73±1.46) kPa,하강정맥재통5 min후실험동물간장탄성평균치위(7.33±0.95) kPa.불동시간점지간간장탄성평균치차이유통계학의의(F=686.99,P<0.01).매개시간점간장탄성치여후일시간점간장탄성치차이균유통계학의의(조단전vs조단후하강정맥압력위15 cm H2 O시,q=22.78,P<0.01;조단후하강정맥압력위15 cm H2 O시vs조단후하강정맥압력위20 cm H2 O시,q=15.30,P<0.01;조단후하강정맥압력위20 cm H2 O시vs조단후하강정맥압력위25 cm H2 O시,q=22.50,P<0.01;조단후하강정맥압력위25 cm H2 O시vs재통후,q=61.38,P<0.01).간장탄성평균치여하강정맥압력지간정현저정상관(r=0.943,P<0.01).결론하강정맥압력승고가제고간장탄성치,차여정맥압력정현저상관.
@@@@Objective To discuss the effect of the pressure of inferior vena cava on the liver stiffness.Methods Sixteen New Zealand rabbits were used in this study ,in which the inferior vena cava was ligated in the level superior to the secondary porta of liver .Heparinized normal solution was infused to increase the pressure of inferior vena cava to 25 cm H2 O (1 cm H2 O=0.098 kPa),and liver stiffness was measured before and after ligation and under venous pressure of 15 cm H2 O,20 cm H2 O and 25 cm H2 O. Results Liver stiffness was (7.57 ±0.99) kPa before ligation,and was (14.40 ±0.78) kPa,(18.99 ±1.22) kPa and (25.73 ±1.46) kPa respectively when the venous pressure was 15 cm H2 O,20 cm H2 O and 25 cm H2 O. Five minutes after recanalization the liver stiffness decreased to (7.33 ±0.95) kPa.There was a significant difference in liver stiffness among different time points ( F =686.99, P <0.01).Multi-comparison was performed,and significant differences were observed on liver stiffness in each adjacent pair (pre-ligation vs 15 cm H2 O,q=22.78,P<0.01;15 cm H2 O vs 20 cm H2 O,q=15.30,P<0.01;20 cm H2 O vs 25 cm H2 O, q=22.50,P <0.01;25 cm H2 O vs recanalization,q =61.38,P <0.01).A significant correlation was observed between liver stiffness and venous pressure (r=0.943,P<0.01).Conclusion The value of liver stiffness was significantly affected by pressure of inferior vena cava and there is a significant correlation between the venous pressure and liver stiffness .