CAJ | 학술논문

为探讨经皮脾门静脉核素显像预测肝硬化食管静脉曲张破裂出血的价值，对40例肝炎后肝硬化和12例非肝病患者（对照组）进行经皮脾门静脉核素显像和胃镜检查。结果显示，根据心-肝曲线特点将肝硬化分为门静脉高压无分流型（Ⅰ型）、有分流型（Ⅱ型）、有侧支循环型（Ⅲ型）及完全肝外分流型（四型）。肝硬化组门体分流指数（PSSI）为0.541±0.128，显著高于对照组0.192±0.086（P＜0.01）；Ⅲ型和Ⅳ型的PSSI显著高于Ⅰ、Ⅱ型（P＜0.01）；F2、3组与F0、1组、红色征（＋）组与红色征（－）组，以及出血组与非出血组之间PSSI均有显著性差异（P＜0.01），PSSI＞0.62时，食管静脉曲张破裂出血发生率显著增高。提示经皮脾门静脉核素显像可作为预测肝硬化食管静脉曲张破裂出血的重要手段。
위탐토경피비문정맥핵소현상예측간경화식관정맥곡장파렬출혈적개치，대40례간염후간경화화12례비간병환자（대조조）진행경피비문정맥핵소현상화위경검사。결과현시，근거심-간곡선특점장간경화분위문정맥고압무분류형（Ⅰ형）、유분류형（Ⅱ형）、유측지순배형（Ⅲ형）급완전간외분류형（사형）。간경화조문체분류지수（PSSI）위0.541±0.128，현저고우대조조0.192±0.086（P＜0.01）；Ⅲ형화Ⅳ형적PSSI현저고우Ⅰ、Ⅱ형（P＜0.01）；F2、3조여F0、1조、홍색정（＋）조여홍색정（－）조，이급출혈조여비출혈조지간PSSI균유현저성차이（P＜0.01），PSSI＞0.62시，식관정맥곡장파렬출혈발생솔현저증고。제시경피비문정맥핵소현상가작위예측간경화식관정맥곡장파렬출혈적중요수단。
To evaluate the value of per-splenic scintigraphy for the prediction of esophageal varices（EV）bleeding in patients with liver cirrhosis.The spleno-portal vein shape and portosystemic shunt index（PSSI）were determined through portal circulation imaging by using intrasplenic injection of99mTc-Phytate.Severity of EV was also observed by gastroscopy.Results showed that the liver cirrhosis were separated into four type，namely nonshunt，shunt，with collateral vein and full-extrahepatic shunt type by per-splenic scintigraphy.The PSSI of controls was 0.192±0.086，cirrhosis group was 0.541±0.128（P＜0.01）.There were significant differences between the nonshunt／shunt type and with collateral vein／full-extrahepatic shunt type in PSSI（mean±SD，0.455±0.098，0.643±0.123，P＜0.01）.There existed a significant difference between PSSI and severity of EV（P＜0.01），including red colour sign（Rc）（＋）and Rc（－）（P＜0.01），F0、1 and F2、3（P＜0.01）.The esophageal varices bleeding patients had a significantly higher level in PSSI than the nonbleeding（P＜0.01）.The PSSI＞0.62 may be the warning figures of variceal bleeding.It suggests that the per-splenic scintigraphy be one of efficient and safe method for predicting the hemorrhage from esophageal varices in patients with liver cirrhosis.