To Observe The Application Of ARFI And Clinical Significance Of The Hemodynamic Changes Of HA In The Cirrhotic Patients Infected HBV With The Child-Pugh Classification And Score

Objective: To explore the value of the application of ARFI and the clinical significance of the hemodynamic changes of HA in the liver function test and provide reference data and clinical values for diagnosis and treatment of cirrhotic patients.Methods: A total of 77 cases infected HBV who were admitted to our hospital form January to November in 2014 were recruited.According to the Child-Pugh classification,33 cases were Grade A、22 cases were Grade B and 21 cases were Grade C.Meanwhile,30 volunteers were recruited.All the liver function indicators such as PT、total bilirubin of the volunteers were in the normal ranges.All cases were imagined with Siemens Acuson S2000 equipped with 5L1 probe、ARFI imaging software and phlip IU-22 equipped with 5L1 probe.Before the imaging,the liver function indicators were examined.During the process of the hemodynamic imaging, the mean PSV and the mean RI of the healthy volunteers and the cirrhotic patients with different Child-Pugh classifications were measured by Color Doppler ultrasound. During the process of the VTQ,firstly,place the region of interest(ROC),At 1cm of the surface of the anterior lobe of the liver firstly,get a clear two-dimensional image and then switch to the sound tissue palpation quantitative imaging(virtual touch tissue quantification, VTQ) mode to get the SWV of the healthy volunteers and patients with different Child-Pugh grades.Each echo was measured three times and the mean of the SWV was taken as the result of each echo.During the process of the imaging,each patient was required to hold the breath and the blood vessels within the tissue were tried to avoid.All the results were analyzed with SPSS.13.0 software.Continuous data wear expressed with mean±SD.The mean between two groups was compared by t-test and the mean among different groups were compared by analysis of variance(ANOVN).The data using chi-square test to P <0.05 was considered significantly.The relationships between two variances were used with Liner correction.Finally,discuss the SWV variances between the volunteers and cirrhotic patients with different Child-Pugh grades、explore the hemodynamic changes of HA between the volunteers and cirrhotic patients with different Child-Pugh grades、analyses the relationship between SWV、the hemodynamic changes of HA and the Child-Pugh grades.Results:1 The mean SWV of the liver in volunteers is(1.06±0.02)m/s.The mean SWV of the liver in the cirrhotic patients is(2.19±0.49)m/s.The mean SWV of the liver in the cirrhotic patients is more significantly increased than the mean SWV of the liver in volunteers and there is statistically significant of the variances of the mean SWV between the two groups(P<0.05). The mean SWV between the volunteers and the cirrhotic patients for individual grade according to Child-Pugh classification is statistically significant different.2 The mean SWV in cirrhotic patients is increasing according to the Child-Pugh grade and the variance between the groups is statistically significant different.3 The correction between the increasing SWV of the cirrhotic patients and the increasing stage of the liver function is the positive. The Spearman’s correlation coefficient is 0.93 and the result is statistically significant different.4 The mean PSV and RI of HA in the healthy volunteers is(43.5±2.63)m/s and(0.6±0.09) respectively.According to the study,the PSV and RI of HA in cirrhotic patients is more significantly increased than the PSV and RI of HA in healthy volunteers and there is statistically significant of the variances between the two groups(P<0.05). The mean PSV and RI of HA between the volunteers and the cirrhotic patients for individual grade according to Child-Pugh classification is statistically significant different. The mean PSV and RI of HA in cirrhotic patients is increasing according to the Child-Pugh grade and the variance between the groups is statistically significant different5 The correction between the increasing PSV and RI of HA in the cirrhotic patients and the increasing stage of the liver function is the positive. The Spearman’s correlation coefficient is 0.70、0.72 respectively and the result is statistically significant different.Conclusion:1 The mean SWV in the cirrhotic patients is largely increasing than the mean SWV in the healthy volunteers and the result of the mean SWV in cirrhotic patients is increasing according to the Child-Pugh grades.The correction between the SWV and the Child-Pugh score is positively.The ARFI imaging can be used to evaluate the liver function originanly and provide clinical significance for the diagnosis and treatment of the cirrhosis disease.2 The mean PSV and RI of HA in the cirrhotic patients is largely increasing than the mean PSV and RI of HA in the healthy volunteers and the result of the mean PSV and RI of HA in cirrhotic patients is increasing according to the Child-Pugh grades.The correction between the PSV、RI of HA and the Child-Pugh score is positively.The hemodynamic changes of HA can be used to evaluate the damage of the liver tissue and provide clinical significance for the diagnosis and treatment of the cirrhosis disease.