| Obective:To evaluate the hepatosplenic hemodynamic changes of patients with pulmonary hypertension by ultrasound,and analyze the value of the hemodynamic changes in the diagnosis of pulmonary hypertension.Method:Patients with pulmonary hypertension admitted to the Department of Cardiology of the First Hospital of Jilin University from January to November 2022 were selected as case group,and 13 cases with pulmonary embolism,hepatitis,pleural effusion and abnormal liver function were excluded,and finally 47 cases(18males,29 females,aged 23-69 years,average age 48 years),including 9 cases of fatty liver.Randomly selected healthy people in the physical examination Center of the First Hospital of Jilin University during the same period according to gender and age matching as the control group,and a total of 50 cases(23 males,27 females,age23-66 years,average age 47 years)were included,including 11 cases of fatty liver.PHILIPS EPIQ5 ultrasonic Doppler instrument 1-5MH abdominal convex array probe was used to observe hemodynamic changes,and the inner diameter,spectrum and flow rate of the middle hepatic vein,portal vein,superior mesenteric vein,splenic vein,peak flow rate of hepatic artery and splenic artery,end-diastolic flow rate,RI,PI,liver stiffness,were measured at the end of deep inspiration of the subject.We divided the spectrum types of intrahepatic veins into: five-phase wave(A,C,S,V,D wave),four-phase wave(A,S,V,D wave),three-phase wave type I(A,S,V wave),three-phase wave type II(S,V,D wave),biphasic wave(The A,S,and V waves are all retrograde,and the D waves are prograde)and single-phase wave(band).IBM SPSS 26 statistical software was used to analyze the data,the quantitative data were described by mean ± standard deviation,the two-sample t-test or rank sum test was used for comparison between the two groups,and the univariate ANOVA test was used between the multiple groups.The qualitative data are described by frequency(composition ratio),and the chi-square test or Fisher exact probability method is used for comparison;In the case group,the method of Spearman correlation analysis was used to explore the relationship between related factors and outcomes,and P<0.05 was statistically significant.Results:1)There were no significant differences in gender,age,body mass index,diastolic blood pressure,and whether or not fatty liver was between the two groups(P>0.05).2)Compared between the two groups,the inner diameter of the intrahepatic vein,splenic artery resistance index,splenic artery pulse index and liver hardness values in the case group were higher than those in the control group,and the differences were statistically significant(P<0.05).3)There were no significant differences in portal vein temporal phase and splenic vein temporal phase between the two groups(P>0.05),and the difference in portal pulse ratio was statistically significant(P<0.05).4)There was no correlation between liver hardness and age,time of illness,and pressure value of pulmonary artery measured by echocardiography(P>0.05).5)Comparative analysis of LS and PR in patients with PH without heart failure was not statistically significant(P>0.05).6)Compared with the control group,there were three-phase wave type I(A,S,V wave)and biphasic wave in the spectrum waveform of the intrahepatic vein in the case group,and the peak flow rate of A wave,peak flow rate of S wave,A/S,A/(S+D)were increased,and the differences were statistically significant(P<0.05).7)The LS of the four-phase wave of the intrahepatic venous spectrum of PH patients was significantly higher than that of the biphasic wave,and the differences were statistically significant(P<0.05).Conclusion:1)Patients with pulmonary hypertension have increased liver hardness than healthy people.2)The hepatosplenic hemodynamics of patients with pulmonary hypertension are changed,compared with healthy people: the inner diameter of the veins in the liver is widened,and the splenic artery resistance index and pulse index are increased;elevated portal vein spectrum pulsatile;There were three-phase wave type I and biphasic waves in the spectrum of veins in the liver,and the peak flow rate of A wave,peak flow rate of S wave,A/S,A/(S+D)increased. |
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