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增强CT评估肝硬化患者自发性门体分流研究

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目的 探讨增强CT评价肝硬化门静脉高压患者自发性门体分流(spontaneous portosystemic shunts,SPSS)的影像价值及相关临床特征.方法 回顾性收集 2020 年 6 月至 2022 年 7 月于盘锦市中心医院就诊的肝硬化患者,进行腹部增强CT检查评价自发性门体分流存在、大小及类型,进行统计学分析,并记录相关临床及实验室指标.结果 本研究共纳入 119 例肝硬化患者.无SPSS组、SPSS<8mm组与SPSS≥8mm组三组患者的总胆红素、白蛋白、凝血酶原时间、国际标准化比值、Child-Pugh分级、肝性脑病、门静脉血栓、肾静脉直径比较,差异有统计学意义(P<0.05).多因素Logistic分析可以发现Child-Pugh C级、门静脉血栓为发生SPSS≥8mm的独立危险因素.无SSRS组、SSRS组中,尿酸值、胃左静脉直径、左肾静脉直径比较,差异有统计学意义(P<0.05).结论 通过增强CT可尽早发现SPSS的存在,存在SPSS特别是直径≥8mm的患者肝功能更差,更易发生门静脉血栓.SPSS在一定程度上能反映患者的肝硬化状态.
Study of spontaneous portosystemic shunts in patients with cirrhosis evaluated by enhanced CT
Objective To investigate the imaging value and associated clinical features of enhanced CT evaluation of spontaneous portosystemic shunts(SPSS)in patients with cirrhotic portal hypertension.Methods Patients with cirrhosis who attended Panjin Central Hospital from June 2020 to July 2022 were retrospectively collected to evaluate the presence,size and type of spontaneous portal shunts for statistical analysis,and relevant clinical and laboratory indices were recorded.Results A total of 119 patients with liver cirrhosis were included in this study.Total bilirubin level,albumin level,prothrombin time,international normalized ratio,Child-Pugh grade,hepatic encephalopathy,portal vein thrombosis,and renal vein diameter were all statistically significant difference(P<0.05)compared to the three groups of patients in the no-SPSS,SPSS<8mm and SPSS≥8mm groups.Multi-factor logistic analysis could identify Child-Pugh grade C and portal vein thrombosis as independent risk factors for the occurrence of spontaneous splenorenal shunt(SSRS)≥8mm.In the group without SPSS and in the group with SSRS,there was a statistically significant difference(P<0.05).When comparing uric acid values,left gastric vein diameter and left renal vein diameter.Conclusion The presence of SPSS can be detected early by enhancing CT.The presence of SPSS,especially in patients with a diameter greater than or equal to 8mm,is associated with poorer liver function and a greater risk of portal vein thrombosis;the presence of SPSS reflects the patient's cirrhotic state to some extent.

Liver cirrhosisPortal hypertensionSpontaneous portosystemic shuntsLiver functionRenal function

史明君、张祥林

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锦州医科大学附属第一医院放射科,辽宁锦州 121000

肝硬化 门静脉高压 自发性门体分流 肝功能 肾功能

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(5)
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