Color Doppler Ultrasonographic Analysis On The Impendence Indices Of Hepatic And Splenic Artery In Liver Cirrhosis Patients

Objectives:To observe and analyze the hepatic and splenic artery impendence indices in liver cirrhosis patients with different liver function and various physiological state,to explore the relationship between the hepatic and splenic artery impendence indices in liver cirrhosis patients with portal hypertension and esophageal varices and in order to reduce the occurrence of esophageal variceal bleeding risk.Methords:40 patients with liver cirrhosis and 43 non-cirrhotic controls were studied. 40 liver cirrhosis patients was divided into 22 with positive bleeding history and 18 negative bleeding history. Doppler sonographic machine(Mindray DC~6)were used.The portal vein(PV),right heptic artery(HA) and splenic artery(SA) was scanned in the fasting and postprandial state. Time average maximum velocity and blood flow volume of portal vein(PVTAMAX,PVQ),resistive index and pulsatility index of hepatic artery (HARI,HAPI),resistive index and pulsatility index of splenic artery(SARI,SAPI)was measured.and portal hypertension index(PHI) was calculated finally. Cirrhosis patients was followed up within a year(from January 2008 to December 2008) in accordance with its bleeding history and all cirrhosis patients were performed with endoscopy, and divided into three degrees, mild (F1), moderate ( F2) and severe (F3). The liver function, blood routine and whether or not with ascites of patients was examined. Results were expressed as incidence rate and mean±standard error of the mean.Analysis of variance was used for three intergroup difference.Chi~square test was used for intergroup comparison of incidence rate. Spearman level correlation analysis was used for correlation analysis.Logistic regression was analyzed the related risk factors.Result:1. As compared with control group, the hepatic and splenic artery impendence indices and portal hypertension index were significantly increased in cirrhotics group, the portal vein velocity were significantly lowered in cirrhotics group,but the above indicators have no statistical difference between chronic hepatitis group and normal control group.2. The portal vein velocity and portal hypertension index had significant correlation in cirrhotics group with liver function Child-Pugh classification,but there was no significant correlation between the hepatic and splenic artery impendence indices and liver function Child-Pugh classification.3. The portal vein velocity and flow volume increase, the hepatic artery impendence indices increase were significantly lower than control group.4. The splenic artery impendence and portal hypertension index in F3 subgroup was significantly higher than those in F1,F2 subgroup, the portal vein velocity in F3 subgroup was significantly lower than in F1,F2 subgroup5. Esophageal variceal bleeding was found in 15 (83.3%) of the 18 patients with liver cirrhosis in F3 subgroup.6. Logistic regression showed ascites, liver dysfunction, plate-reduction and esophageal variceal were risk factors related the prevalence of bleeding.Conclusions: The hepatic and splenic artery impendence indices were significantly increased in liver cirrhosis patients. The hepatic arterial buffer response were significantly lowered in liver cirrhosis patients. The portal hypertension index >1.9s/m,combining with liver function, platelet count, ascites situation of liver cirhosis patients can predict esophageal variceal bleeding risk and reduce the upper gastrointestinal endoscopic examination.