乙型肝炎肝硬化并发食管静脉曲张患者超声检测肝脏血流参数和红细胞分布宽度与淋巴细胞比值变化*

doi:10.3969/j.issn.1672-5069.2023.04.019

Abstract

Abstract: Objective The aim of this study was to investigate the changes of hepatic blood flow parametersobtained by ultrasonography and red blood cell distribution width (RDW) to lymphocyteratio (RLR) in patients with liver cirrhosis andesophageal varices (EV). Methods 188 patients with hepatitis B livercirrhosis and EV were encountered in our hospital between April 2018 and March 2021, and all underwent Doppler ultrasonography and contrast-enhanced ultrasonography to obtain hepatic vein damping index (HV-DI), portal vein velocity (PVV), internal diameter of portal vein (PVD) and portal vein congestion index (PV-CI), andgastroscope to determine the severity of EV. Results The gastroscopy found EV in 120 patients; the PVV and HVAT in patients with EV were (15.2±2.3)cm/s and (15.3±2.4)s, much lower than [(18.9±2.4)cm/s and (22.1±3.5)s, P<0.05], while the PVD, PV-CI, HV-DI and RLR were (1.6±0.2)cm, (0.4±0.1)cm/s, (0.8±0.1) and (24.2±3.5), much higher than [(1.3±0.2)cm, (0.2±0.1)cm/s, (0.6±0.1) and (9.2±1.1), respectively, P<0.05] in patients without EV; the PVV and HVAT in 33 patients with severe EV were (12.8±2.5)cm/s and (8.2±0.9)s, much lower than [(14.2±2.1)cm/s and (12.5±3.1)s, P<0.05] in 42 patients with moderate EV or [(17.9±2.1)cm/s and (23.1±3.4)s, P<0.05] in 45 patients with mild EV, while the PVD, PV-CI, HV-DI and RLR were (2.2±0.3)cm, (0.7±0.1)cm/s, (1.5±0.1) and (32.7±4.1), all much higher than [(1.5±0.1)cm, (0.4±0.1)cm/s, (0.7±0.1) and (26.7±2.8), respectively, P<0.05] in patients with moderate EV or [(1.3±0.1)cm, (0.2±0.1)cm/s, (0.4±0.1) and (15.6±1.5), respectively, P<0.05] in patients with mild EV; during the 12-month follow-up, the EV bleeding (EVB) occurred in 72 cases, and the PVV and HVAT in patients with EVB was significantly lower, while the PVD, PV-CI, HV-DI and RLR was significantly higher than in patients without EVB (P<0.05). Conclusion The monitoring of hepatic blood flow parameters by ultrasonography and RLR might provide clues for predicting EVB in patients with liver cirrhosis and EV, which warrants further clinical investigation.

Key words: Liver cirrhosis, Esophageal varices, Hepatic vein damping index, Portal vein congestion index, Red blood cell distribution width

Zhao Xiaoli, Qin Bo, Li Dongfeng, et al. Changes of hepatic blood flow parameters by ultrasonography and red blood cell distribution width to lymphocyte ratio in patients with hepatitis B cirrhosis and esophageal varices[J]. Journal of Practical Hepatology, 2023, 26(4): 528-531.

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Changes of hepatic blood flow parameters by ultrasonography and red blood cell distribution width to lymphocyte ratio in patients with hepatitis B cirrhosis and esophageal varices

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