The Ultrasound Diagnosis Of Cirrhotic Portal Hypertension And Hemodynamic Change

Object: The research measures the index of the hemodynamic change for the normal people and patients with liver cirrhosis by doppler ultrasound and then get the correlation between cirrhotic portal hypertension and the hemodynamic change of pulmonary and abdomen. In this way, the research gets the basis for the diagnosis of cirrhotic portal hypertension by doppler ultrasound and studies further on the change of systemic hemodynamic when hypertension.Methods: To choose 65 hepatocirrhosis cases (21 Grade A hepatocirrhosis cases, 27 Grade B hepatocirrhosis cases, 17 Grade C hepatocirrhosis cases in order to Child-Pugh grading method) and 24 normal people of control, the research measures the vessel diameters and blood flow velocity of portal vein, hepatic artery, splenic artery and splenic vein by Doppler ultrasound so as to evaluate the hemodynamic change in abdomen. Meanwhile, the research measures the right atrium, right ventricular and recurrent velocity in tricuspid valve of the 65 hepatocirrhosis cases and the 24 control cases so as to estimate the pulmonary artery systolic pressure. All the results, which were accurated to two bit after the decimal point, were analyzed by statistical software SPSS 13.0.Results:1. Results for the portal vein and hepatic artery: All the index of the control group and Grade A hepatocirrhosis group showed no statistical difference. The index of the control group, Grade B and Grade C hepatocirrhosis group showed statistical difference. Comparing the results of hepatic vessel, the index of the control group, Grade A hepatocirrhosis group, and Grade B hepatocirrhosis group showed statistical differences respectively. The index of DPV and PVV of Grade B and Grade C hepatocirrhosis group shows statistical differences while HAPI and LVI not.2. Results for hepatic artery, splenic artery index: HAPI, HARI, LVI showed statistical differences between the control group and grade A hepatocirrhosis group while SpAPI and SpARI not. The entire index shows statistical differences between grade A and B hepatocirrhosis group. SpAPI and SpARI shows statistical differences between grade B and C hepatocirrhosis group while HAPI, HARI and LVI not. The index PHI of four groups showed statistical difference.4. Results for hemodynamic change of right heart and pulmonary: The results of the recurrent velocity in tricuspid valve as well as the diameters of right atrium and right ventricular showed no statistical differences between control group, grade A and B hepatocirrhosis groups while the estimation results of pulmonary artery systolic pressure shows statistical difference. All the indexes shows statistical differences between grade B and C hepatocirrhosis groups. Conclusion:1,When cirrhotic portal hypertension the velocity in portal vein slows down, the HARI, HAPI, SpARI and SpAPI increase. The change of hepatic artery indexes is more sensitivity so it's suitable for grade A hepatocirrhosis. Meanwhile, the change of splenic artery index is important for the severe portal hypertension.2,As the aggravation of hepatocirrhosis clinical symptoms, the ultrasonic indications for right heart failure, which is the increasing of the diameters of right atrium and right ventricle, the acceleration and enlargement of tricuspid regurgitation, becomes obviously, as well as the pulmonary arterial pressure.