彩色多普勒超声及FibroScan技术对慢性肝纤维化疾病评价

发布时间：2018-04-22 08:46

本文选题：彩色多普勒 + 超声　；参考：《大连医科大学》2014年硕士论文

【摘要】：第一部分彩色多普勒超声对慢性肝纤维化疾病的评价目的：探讨彩色多普勒超声对慢性肝纤维化疾病的诊断价值。方法：选择180例慢性乙型肝炎患者作为研究对象，按肝活检病理诊断肝纤维化分级进行分组：0级(S0)40例，1级(S1)38例，2级(S2)37例，3级(S3)40例，4级(S4)35例。应用彩色多普勒超声获得下列参数：门静脉主干内径(mPVD)、门静脉主干血流平均速度(mPVm)、门静脉血流量（mPBF）、门静脉淤血指数（CI）、脾静脉内径（SVD）、脾静脉平均血流速度（sVm）、脾静脉血流量（sVBF）。结果同肝组织活检的病理纤维化分期进行相关性研究。结果：门静脉主干内径(mPVD)、门静脉主干血流平均速度(mPVm)、门静脉淤血指数(CI)和脾静脉内径(sVD)在肝纤维化分期各组间比较差异有统计学意义(P0.05)，，两两比较均具有明显差异（P均0.05)。门静脉主干内径、脾静脉内径、门静脉的淤血指数与肝纤维化分期呈正相关关系(r=0.44，0.41，0.42，P均0.05)。门静脉的平均流速与肝纤维化分期呈负相关关系（r=-0.43，P 0.05）。结论：彩色多普勒超声作为一项常规的超声技术，获得的门静脉及脾静脉的相关参数对于肝纤维化的判定具有一定的诊断价值。第二部分 FibroScan技术对慢性肝纤维化疾病的评价目的：探讨应用FibroScan技术评价慢性乙型肝炎及肝硬化患者肝纤维化程度的价值。方法：选择各类慢性肝病患者360例作为研究对象，其中分为乙型肝炎病毒携带者组（112例），慢性乙型肝炎组（130例）、肝硬化组（118例）。应用FibroScan技术获得肝脏瞬时弹性硬度测定值（FibroScan值，FS值）(单位kPa)，各组间进行比较。结果：各组间FS值比较差异有统计学意义(P 0.05)，两两比较结果：CHB组乙肝病毒携带者组(P 0.05)，肝硬化组乙肝病毒携带者组(P 0.05)，肝硬化组CHB患者组(P 0.05)。结论：FibroScan技术可以较为准确地评价慢性肝病患者的肝脏纤维化程度，对于肝纤维化的早期诊断及治疗具有重要的临床意义。
[Abstract]:Part one Evaluation of chronic Hepatic Fibrosis by Color Doppler Ultrasound Objective: to evaluate the diagnostic value of color Doppler ultrasound in chronic hepatic fibrosis. Methods: one hundred and eighty patients with chronic hepatitis B were divided into 40 cases of grade 1 S1 and 38 cases of grade 2 S2P, 37 cases of grade 3 of S3 and 40 cases of grade 4 of S4N according to liver biopsy and pathological diagnosis of hepatic fibrosis grade (n = 40, n = 40, n = 40, n = 40, n = 40, n = 35, n = 40, n = 40, n = 40, n = 40, n = 40, n = 40). The following parameters were obtained by color Doppler ultrasound: the main portal vein diameter (PVD), the mean velocity of portal vein blood flow (MPVM), the portal vein blood flow (PVF), the portal vein blood flow (PVF), the portal vein congestion index (PVP), the diameter of the splenic vein (SVD), the mean velocity of the splenic vein (SVV), and the splenic venous blood flow (sVBFV). Results correlation study was carried out with pathological fibrosis stage of liver biopsy. Results: there were significant differences in the diameter of the main portal vein (MPVD), the mean velocity of portal vein blood flow (MPVM), the portal vein congestion index (CI) and the splenic vein diameter (sVD) in hepatic fibrosis stages (P 0.05), and there were significant differences between the two groups (P < 0.05). The diameter of the main portal vein, the internal diameter of the splenic vein and the blood stasis index of the portal vein were positively correlated with the stage of hepatic fibrosis. There was a negative correlation between the mean velocity of portal vein and the stage of hepatic fibrosis. Conclusion: as a conventional ultrasound technique, the parameters of portal vein and splenic vein obtained by color Doppler ultrasound have certain diagnostic value for hepatic fibrosis. Part two Evaluation of chronic hepatic fibrosis by FibroScan Objective: to evaluate the value of FibroScan in evaluating the degree of hepatic fibrosis in patients with chronic hepatitis B and liver cirrhosis. Methods: 360 patients with chronic liver disease were divided into three groups: hepatitis B virus carrier group (112 cases), chronic hepatitis B group (130 cases) and cirrhosis group (118 cases). The FibroScan technique was used to determine the instantaneous elastic hardness of the liver and to compare the values of FibroScan and FS (unit KPA) among the groups. Results: there were significant differences in FS values among the groups (P 0.05). The results showed that there was no significant difference between the two groups in the hepatitis B virus carriers group (P 0.05), the liver cirrhosis group (P 0.05) and the cirrhosis group (CHB) group (P 0.05). Conclusion the technique of: FibroScan can accurately evaluate the degree of hepatic fibrosis in patients with chronic liver disease and has important clinical significance for the early diagnosis and treatment of liver fibrosis.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R575.2

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