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目的分析彩色Dopp ler超声检查参数诊断肝硬化门静脉高压症的敏感性和特异性,并初步提出在中国部分人群中上述参数的正常参考值。方法2001年7月2~004年3月间,符合入选标准的共99例可疑肝硬化患者和部分正常人群(因其他疾病接受腹部手术的志愿者,在手术中取肝组织进行病理检查),经肝穿刺或手术中取肝组织活检分为正常组(n=51)和肝硬化组(n=48),分别经Dopp ler超声检测门静脉流速(PVV)、肝动脉搏动指数(HA-PI),计算肝血管指数(LVI),根据ROC曲线分析上述指标在诊断肝硬化和门静脉高压症方面的敏感性和特异性,并推算出正常参考值。结果与正常组比较,肝硬化组的PVV明显降低,(11.0+2.5)cm/svs(16.9+2.9)cm/s(P<0.001);HA-PI明显增高,1.2+0.2vs0.9+0.2(P<0.001);LVI显著降低,9.1+0.6vs19.1+1.9(P<0.001)。对于诊断肝硬化门静脉高压症的敏感性和特异性,PVV为14 cm/s时,分别为91.7%和91.7%;HA-PI为1.1时,分别为82.6%和83.3%;LVI为10时,分别为93.8%和93.8%。结论彩色Dopp ler超声检查参数中,以LVI诊断肝硬化门静脉高压症的敏感性和特异性最高,可作为无创性早期诊断参数之一,并可为活体部分肝移植供体的选择提供一个初步的遴选。
Objective To analyze the sensitivity and specificity of color Doppler sonography in the diagnosis of portal hypertension in cirrhosis and to propose the normal reference values of the above parameters in some Chinese population. Methods Between July 2001 and March 2004, a total of 99 patients with suspected cirrhosis and some normal subjects who met the inclusion criteria (volunteers who underwent abdominal surgery due to other diseases and took liver tissue for pathological examination during the operation) The liver biopsies were divided into normal group (n = 51) and cirrhosis group (n = 48) by liver biopsy or surgery. The PVV, HA-PI, , Calculated liver vascular index (LVI), according to ROC curve analysis of the above indicators in the diagnosis of cirrhosis and portal hypertension sensitivity and specificity, and calculate the normal reference value. Results Compared with the normal group, the PVV in cirrhosis group was significantly lower (11.0 ± 2.5) cm / svs (16.9 ± 2.9) cm / s (P <0.001) (P <0.001); LVI decreased significantly, 9.1 + 0.6 vs 19.1 + 1.9 (P <0.001). The sensitivity and specificity for diagnosing cirrhosis and portal hypertension were 91.7% and 91.7% for the PVV of 14 cm / s and 82.6% and 83.3% for the HA-PI of 1.1, respectively. When the LVI was 10, 93.8% and 93.8% respectively. Conclusion The color Doppler sonographic parameters in the diagnosis of liver cirrhosis with portal hypertension have the highest sensitivity and specificity, which can be used as one of the noninvasive early diagnosis parameters and provide a preliminary Selection.