右心衰肝静脉频谱异常对肝脏弹性模量的影响Influence of Hepatic Vein Anomaly Caused by Right Heart Failure on Liver Elastic Modulus
方彦鹏,段庆红,焦俊,胡小丽,于绍梅
FANG Yanpeng,DUAN Qinghong,JIAO Jun,HU Xiaoli,YU Shaomei
摘要(Abstract):
目的:探讨右心衰肝静脉频谱(HVS)异常对肝弹性模量(LEM)的影响。方法:随机选取无肝脏自身疾病、临床确诊的48例右心衰患者作为研究组,40例健康成年人志愿者作为健康对照组,利用彩色多普勒超声测量HVS,同时利用实时剪切波弹性成像测量LEM,分析右心衰HVS异常对LEM的影响。结果:(1)健康对照组HVS均呈HV1型,37例LEM检查成功,LEM均值为(6.08±0.85)k Pa;(2)研究组43例检测LEM有效,其中25例HVS呈HV2型,LEM均值为(9.51±1.46)k Pa;18例HVS呈HV3型,LEM均值为(23.93±6.82)k Pa;(3)健康对照组和研究组整体比较采用单因素方差分析(ANOVA),LEM均值差异有统计学意义(F=175.57,P=0.000)。Tamhanes T2检验型间两两比较(HV1型与HV2型、HV1与HV3型、HV2型与HV3型)LEM均值比较,差异有统计学意义(T=-9.14、-11.44、-9.81,P=0.000、0.000、0.000)。结论:右心衰致HVS异常对LEM影响明显,随着HVS分型越高,LEM也逐渐增高,右心衰是影响LEM的一个重要因素。
Objective: To investigate the effect of hepatic vein frequency spectrum( HVS) abnormality caused by right heart failure on hepatic elastic modulus( LEM). Methods: Forty-eight patients with right heart failure were randomly selected as study group and 40 healthy adult volunteers as control group. The HVS was measured by color Doppler ultrasound and the effect of HVS on LEM was analyzed by real-time shear wave elasticity imaging. Results:( 1) HVS in healthy control group was HV1,and LEM of 37 cases were successfully detected,the mean value of LEM was( 6. 08 ± 0. 85) k Pa;( 2) LEM of 43 cases were successfully detected in the study group,and HVS of 25 cases was HV2,the mean value of LEM was( 9. 51 ± 1. 46) k Pa,HVS of 18 cases were HV3,and the mean LEM was( 23. 93 ± 6. 82) k Pa;( 3) There was significant difference of LEM between control group and study group( F = 175. 57,P = 0. 000). The difference of LEM between type HV1 and HV2,type HV1 and HV3,type HV2 and HV3 was statistically significant( t =-9. 14,-11. 44,-9. 81; P < 0. 05).Conclusions: HVS abnormality caused by right heart failure has significant effect on LEM,with the increase of HVS score,LEM is gradually increased,and right heart failure is an important factor affecting LEM.
关键词(KeyWords):
成年人;右心衰;肝静脉频谱;肝弹性模量
adult;right heart failure;hepatic vein frequency spectrum;liver elastic modulus
基金项目(Foundation):
作者(Author):
方彦鹏,段庆红,焦俊,胡小丽,于绍梅
FANG Yanpeng,DUAN Qinghong,JIAO Jun,HU Xiaoli,YU Shaomei
DOI: 10.19367/j.cnki.1000-2707.2015.10.034
参考文献(References):
- [1]Kanamoto M,Shimada M,Ikegami T.Real time elastography for noninvasive diagnosis of liver fibrosis[J].J Hepatobiliary Pancreat Surg,2009(4):463-467.
- [2]Chang PE,Lui HF,Chau YP,et al.Prospective evaluation of transient elastography for the diagnosis of hepatic fibrosis in Asians:comparison with liver biopsy and aspartate transaminase platelet ratio index[J].Aliment Pharmacol Ther,2008(1):51-61.
- [3]Kuroda H,Kakisaka K,Tatemichi Y,et al.Non-invasive evaluation of liver fibroisis using acoustic radiation force impulse imaging in chroni chepatitis patients with hepatitis C virus infection[J].Hepatogastruenterology,2010(57):1203-1207.
- [4]Bavu E,Gennisson JL,Osmanski BE,et al.Liver Fibrosis staging using Supersonic Shear Imaging:a clinical study on142 patients[J].J Hepatology,2012(3):1167-1169.
- [5]Sumeet K.Asrani,Jayant A.Talwalkar,Patrick S.Kamath,et al.Role of magnetic resonance elastography in compensated and decompensated liver disease[J].Journal of Hepatology,2014(60):934-939.
- [6]梁雄波,程小飞,李紫平.脉冲多普勒超声测定肝硬化患者肝静脉频谱与Fibroscan测值的关系研究[J].中国肝病杂志,2014(2):24-26.
- [7]Lee DM.Factors associated with liver stiffness in chronic liver disease[J].Korean J Hepatol,2009(4):464-73.
- [8]单茜,迟坤,石龙.慢性肝病肝纤维化的肝静脉血流频谱分析[J].中国超声诊断杂志,2004(5):346-347.
- [9]孟繁坤,郑颖,葛辉玉,等.慢性肝炎肝静脉彩色多普勒超声频谱改变与肝纤维化分期相关性的研究[J].中华超声影像学杂志,2006(15):297-298.
- [10]Bolondi L,Bassils,Gaiani S,et al.Liver cirrhosis:changes of Doppler waveform of hepatic veins[J].Radiology,1991(178):513-516.
- [11]王一娇,唐少珊,赵国家.超声实时组织弹性成像评价大鼠肝纤维化分期[J].中国医学影像学杂志,2013(4):245-248.
- [12]Koizumi Y,Hirooka M,Kisaka Y,et al.Liver fibrosis in patients with chronic hepatitis C:noninvasive diagnosis by means of real-time tissue elastography-establishment of the method for measurement[J].Radiology,2011(2):610-617.
- [13]Roulot D,et al,Transient elastography as a screening tool for liver fibrosis and cirrhosis in a community-based population aged over 45 years[J].Gut,2011(7):977-984.
- [14]Boursier J.Acoustic radiation force impulse:a new ultrasonographic technology for the widespread noninvasive diagnosis of liver fibrosis[J].Eur J Gastroenterol Hepatol,2010(9):1074-1084.
- [15]Ferraioli G.Reproducibility of real-time shear wave elastography in the evaluation of liver elasticity[J].Eur J Radiol,2012(11):3102-3106.
- [16]Sumeet K.Asrani,Jayant A.Talwalkar,Patrick S.Kamath,et al.Role of magnetic resonance elastography in compensated and decompensated liver disease[J].Journal of Hepatology,2014(60):934-939.
- [17]陈光文,宋彬,陈坜桃,等.淤血性肝硬化的影像表现特征探讨[J].实用放射学杂志,2010(1):31-35.
- [18]Schtz T,Hruby S,Colleselli D,et al.A severe complication of mid-urethral tapes solved by laparoscopic tape removal and ureterocutaneostomy[J].Can Urol Assoc J,2013(10):598-600.
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