摘要
用B超测S0～S4组的门静脉 (MPV)、脾静脉 (SPV)内径及脾脏厚度 ,常规方法检测同期外周血WBC、Hb、血小板 (PLT)及血清白蛋白 (ALB)、γ 球蛋白 (γ G)、凝血酶原活性 (PTA) ,以观察上述指标与肝纤维化程度的关系。结果 ,从S0～S4组 ,MPV、SPV及脾增厚的比率逐级上升 ,但各组MPV、SPV增宽比率差异无显著性 (P >0 .0 5) ;脾厚发生较早 ,S1组脾脏增厚的已达 2 8.8% ,与S0组有显著差异 (P <0 .0 5) ,而MPV增宽的仅为 6.2 % ;至S4组 ,脾脏增厚及SPV、MPV增宽比率分别达到 4 3.3%、36.7%、1 6.7%。从S0～S4组 ,WBC、Hb、PLT、ALB、PTA逐级下降 ,γ G逐级上升 ,至S4组 ,WBC、Hb、PLT仍未降至异常值范围 ,而ALB〔( 33.8± 4 .9) g/L〕、PTA〔( 70 .5± 2 1 .6) %〕、γ G〔( 2 3.9± 7.2 ) %〕已经异常。提示脾脏增厚出现较早 ,是反映早期肝纤维化的较好指标 ,其次为SPV增宽 ,MPV增宽出现较晚 ;另外 ,临床上若能排除肝细胞炎症活动的影响 ,当ALB <33.8g/L、PTA <70 .5%、γ G >2 3.9%时 。
In order to study the relationship between liver fibrosis stages and the diameters of main portal vein(MPV), spleen vein(SPV), splenectasis and blood tests, 1 005 patients with chronic hepatitis were divided into groups S0 to S4 according to liver fibrosis stages. The MPV and SPV diameters and splenectasis were measured by ultrasonography. The WBC, Hb, PLT, ALB, γ G, PTA were tested by routinel method. From S0 to S4, the rates of wide MPV and SPV diameters and splenectasis increased gradually. The rates of wide MPV and SPV diameters were not significantly different( P >0.05)among the groups while the rates of splenectasis were significantly different( P <0.05) among the groups. Splenectasis occured earlier. The rate of splenectasis was 28.8% in S1 and it was significantly different between S1 and S0(P<0.05). The rate of wide MPV diameters was only 6.2% in S1. In S4, the rates of splenectasis and wide SPV, MPV diameters were 43.3%, 36.7%, 16.7% respectively. In blood tests, WBC, Hb, PLT, ALB, PTA were gradually decreased and γ G was gradually increased from group S0 to S4 successively. In group S4, WBC, Hb, PLT were still normal, while ALB(<33.8 g/L), PTA(< 70.5% ), γ G(23.9%) were abnormal. Conclusion: The appearance of splenectasis is earlier and it may be more sensitive than SPV and MPV. If the effect of necroinflammatory activity of liver can be excluded, the earlier liver fibrosis may be consided under the conditions ALB< 33.8 g/L, PTA< 70.5% , γ G> 23.9% .
出处
《首都医科大学学报》
CAS
2001年第2期144-146,共3页
Journal of Capital Medical University
关键词
慢性肝炎
肝纤维化
B超
血液学指标
chronic hepatitis
liver fibrosis stage
ultrasonography
blood tests
