肝硬化门静脉高压症患者血流动力学与肝储备功能的关系

M. Jiang
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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. \n \n \nResults \nThe 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). 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引用次数: 0

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功能储备的关系,探讨两者在病情评价中的意义。方法根据Child评分将我院2016年1月~ 2018年1月收治的肝硬化合并PHT患者80例分为A、B、C三个等级,选取同期健康人群35例作为正常对照组。采用彩色多普勒超声检测肝脏血流动力学参数,全自动生化分析仪检测肝脏储备功能项目。采用Pearson方法分析血流动力学指标与肝脏储备功能的相关性,采用logistic多元回归分析肝硬化合并PHT的危险因素。结果门户内静脉的直径(第一项),最大速度的门静脉血流(PVX),指门静脉血流速度(PVM)数量的主要门静脉的血流量(QPV)、白蛋白(铝青铜),cerealthirdtransaminase (ALT)、天冬氨酸转氨酶(AST)、凝血酶原时间(PT)观察组明显高于对照组(P < 0.05),而总胆红素(治疗组)明显低于对照组(P < 0.05)。C级患者DPV、PVX、PVM、QPV水平显著高于A、B级患者(P<0.05);肝功能B级患者DPV、PVX、PVM、QPV水平显著高于A级患者(P<0.05)。肝功能C级患者TBIL水平显著低于A级和B级患者(P<0.05);ALB、ALT、AST、PT显著高于A、B级患者(P<0.05);肝功能分级B组患者TBIL水平显著低于A组(P<0.05), ALB、ALT、AST、PT水平显著高于A组(P<0.05)。肝硬化合并PHT患者DPV、PVM、QPV与PT呈显著正相关(P<0.05), PVM、QPV与TBIL呈显著负相关(P<0.05)。回归分析显示,DPV、PVX、PVM、QPV血流动力学指标及肝脏储备功能指标TBIL、ALB、ALT、AST、PT是肝硬化门脉高压的危险因素。结论血液动力学和肝储备功能指标在不同程度肝硬化合并PHT患者中具有一定的规律性,两者密切相关,可作为评价和监测PHT肝硬化的重要指标。关键词:肝硬化;门静脉高压;血流动力学;肝储备功能
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Relationship between hemodynamics with hepatic reserve function in cirrhotic patients with portal hypertension
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. Key words: Liver cirrhosis; Portal hypertension; Hemodynamics; Hepatic reserve functional
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中国医师杂志
中国医师杂志 Medicine-Medicine (all)
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