彩色多普勒超声诊断慢性乙型肝炎肝纤维化的临床价值

【摘要】  　　目的 探讨彩色多普勒超声检查对慢性乙型肝炎后肝纤维化诊断及程度判断的应用价值。方法 采用彩色多普勒超声检测281例不同程度慢性乙型肝炎患者以及正常对照组(60例)的血流动力学指标，包括门静脉内径（Dpv）、肝静脉内径(Dhv)、脾静脉内径（Dsv）、门静脉血流速度（Vpv）及肝静脉频谱变化等，并利用SPSS 13.0统计软件进行统计学处理。结果 Dpv、Dsv、Dhv、Vpv及肝静脉频谱变化与肝纤维化发展的阶段性一致，尤其是在慢性乙型肝炎的中、重度阶段及肝硬化阶段差异有统计学意义（P＜0.05）。结论 彩色多普勒超声诊断慢性乙型肝炎后肝纤维化具有一定的临床价值，可作为判定肝纤维化程度的指标之一。

【关键词】  慢性乙型肝炎 肝纤维化 血流动力学

　　The clinical value of color Doppler ultrasound in the diagnosis of liver fibrosis in chronic hepatitis B
   
　　Tang Hong，Tang Deping
   
　　Hefei the Sixth People s Hospital，Hefei 230022,China
   
　　［Abstract］  Objective   To study the value of color Doppler ultrasound in the diagnosis and the determination of extent of liver fibrosis in chronic hepatitis B. Methods  The hemodynamic parameters including the portal vein diameter (Dpv), hepatic vein diameter (Dhv), splenic vein diameter (Dsv), portal vein blood flow velocity (Vpv) and hepatic vein frequency spectrum changes were detected by using color Doppler ultrasound in 281 cases of chronic hepatitis B liver cirrhosis varying degrees and normal control group(60 cases), and using SPSS 13.0 statistical software for statistical analysis. Results  The changes of Dpv, Dsv, Dhv, Vpv and hepatic vein frequency spectrum were consistant with the development of liver fibrosis stage, especially in moderate, severe and the liver cirrhosis stages of chronic hepatitis B. Conclusion  Color Doppler ultrasound was valuable in the diagnosis of liver fibrosis in chronic hepatitis B, and can be used as indicator to determine the degree of liver fibrosis.
   
　　［Key words］  Chronic hepatitis B; Liver fibrosis; Hemodynamics

　　肝穿刺活检是目前确诊肝纤维化的金标准，但因具有创伤性难以反复取材做动态观察，而难以在临床广泛应用。彩色多普勒超声具有简便、无创伤性、可进行实时动态观察等特点，通过对肝脏血流动力学的改变及肝静脉频谱的变化检测对诊断肝纤维化及程度的判定有一定的应用价值。

　　1  资料与方法

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