多层螺旋CT门静脉成像评价肝硬化患者肝功能分级价值研究

doi:10.3969/j.issn.1672-5069.2019.03.022

摘要/Abstract

摘要： 目的探讨采用多层螺旋CT门静脉成像（MSCTP）检查对肝硬化患者肝功能分级的评价价值。方法 2015年8月~2017年9月我院收治的肝硬化患者62例,选择同期健康人62例作为对照组,均行MSCTP检查,观察脾静脉（SPV）、肝内门静脉左支（IHLPV）、门静脉主干（MPV）和肝内门静脉右支（IHRPV）直径,并比较不同Child-Pugh分级患者的上述指标及胃左静脉（LGV）直径和食管下段静脉曲张断面数。结果肝硬化患者SPV、IHLPV、MPV和IHRPV直径分别为（14.4±3.6） mm、（13.5±3.1） mm、（17.9±4.2） mm和（13.8±3.9） mm,均显著大于健康人[分别为（8.9±1.7） mm、（9.7±2.3） mm、（11.2±2.9） mm和（9.5±2.5） mm,P<0.05];随着肝功能Child-Pugh分级变差,SPV、IHLPV、MPV和IHRPV直径也逐渐增大[A级为（13.2±2.7） mm、（12.1±3.2） mm、（16.4±4.6） mm和（12.3±3.3） mm,B级为（15.1±3.5） mm、（14.3±3.7） mm、（18.5±4.8） mm和（14.7±3.6） mm,C级为（16.3±4.1） mm、（15.8±4.3） mm、（20.8±5.1） mm和（16.1±4.7） mm,P<0.05],差异显著,LGV直径和食管下段静脉曲张断面数亦逐渐增大或增多[Child-Pugh A级分别为（6.4±1.5） mm和（3.8±1.1）个,B级为（9.1±2.2） mm和（7.4±1.6）个,C级为（9.7±2.6） mm和（7.7±1.8）个],其中Child-Pugh B级或C级与A级比,差异有统计学意义（P<0.05）,而Child-Pugh B级与C级比较,差异无统计学意义（P>0.05）。结论采用MSCTP检查门静脉系统并检测有关指标,能很好地评估肝硬化患者肝功能状态,具有重要的临床意义。

关键词: 肝硬化, 多层螺旋CT, 门静脉, 肝功能分级, 评价

Abstract: Objectiv To investigate the value of multi-slice spiral CT portography （MSCTP） in the evaluation of liver functions in patients with liver cirrhosis. Methods A total of 62 patients with liver cirrhosis and 62 healthy persons in the same period were recruited in this study between August 2015 and September 2017. All the individuals underwent MSCTP and the diameters of splenic vein（SPV）,intra-hepatic left portal vein （IHLPV）,main portal vein （MPV） and intra-hepatic right portal vein （IHRPV） were calculated in the two groups. The above indexes and left gastric vein（LGV） and the section number of esophageal varices in patients with different Child-Pugh class were also compared. Results The diameters of SPV,IHLPV,MPV and IHRPV in patients with liver cirrhosis were （14.4±3.6） mm,（13.5±3.1） mm,（17.9±4.2） mm and （13.8±3.9） mm,significantly greater than [（8.9±1.7）mm,（9.7±2.3） mm,（11.2±2.9） mm and （9.5±2.5） mm,P<0.05] in healthy persons;as the Child-Pugh class deteriorated,the diameters of SPV,IHLPV,MPV and IHRPV increased [（13.2±2.7） mm,（12.1±3.2） mm,（16.4±4.6） mm and（12.3±3.3） mm in patients with Child-Pugh class A,（15.1±3.5） mm,（14.3±3.7） mm,（18.5±4.8） mm and（14.7±3.6） mm in patients with Child-Pugh class B,and（16.3±4.1） mm,（15.8±4.3） mm,（20.8±5.1） mm and（16.1±4.7） mm in with Child-Pugh class C,respectively,P<0.05],and the LGV diameters enlarged,and the number of esophageal varices also increased [（6.4±1.5） mm and（3.8±1.1） in patients with Child-Pugh class A,（9.1±2.2） mm and（7.4±1.6） in with class B,and（9.7±2.6） mm and （7.7±1.8） in with class C,respectively,with the difference between class A and class B or class C statistically significant （P<0.05）. Conclusion MSCTP is of great value in the assessment of liver functions in patients with liver cirrhosis,which warrants further investigation.

Key words: Liver cirrhosis, Multi-slice spiral CT, Portal vein, Liver function class, Evaluation

巴正武, 栗海龙. 多层螺旋CT门静脉成像评价肝硬化患者肝功能分级价值研究[J]. 实用肝脏病杂志, 2019, 22(3): 397-400.

Ba Zhengwu, Li Hailong. Application of multi-slice spiral CT portography in evaluation of liver functions in patients with liver cirrhosis[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(3): 397-400.

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