乙肝肝硬化中医证型及门静脉血流动力学及肝功能分级相关性探究.doc

乙肝肝硬化中医证型及门静脉血流动力学及肝功能分级相关性探究 　【摘要】; 　　［目的］探讨乙肝肝硬化不同证型门静脉血流动力学变化及与ChildPugh分级的关系。［方法］150例乙肝肝硬化患者肝功能按ChildPugh评分分级，利用彩色多普勒超声检测门静脉内径、血流速度，并计算血流量；血生化检查总胆红素、丙氨酸氨基转移酶、门冬氨酸氨基转移酶、白蛋白、球蛋白、凝血酶原活动度，分析不同证型与门静脉血流动力学及肝功能分级的相关性。［结果］肝肾阴虚证、脾肾阳虚证、血瘀证肝硬化患者门静脉主干内径明显增宽，与湿热内蕴证与比较有统计学意义（Plt;0.05）；血瘀证门静脉血流流速和血流量减低，与肝气郁结证比较有统计学意义（Plt;0.01）；肝气郁结证以A级为主，与其他证型间比较有显著性差异（Plt;0.05），肝肾阴虚证、脾肾阳虚证、血瘀证以C级为主，与其他三型有显著性差异（Plt;0.05）。［结论］肝气郁结证、湿热内蕴证是肝炎肝硬化早期，病情较轻，脾肾阳虚证、血瘀证一般病程较长，门静脉流速减低、血流量减少，肝功能损害加重。 【关键词】; 肝硬化 辨证分型 门静脉 肝功能 　　Abstract：［Objective］ Study on the characteristics of different traditional Chinese medical syndrome of Bhepatocirrhosis relating with hemodynamics of the portal vein and liver functions classification.［Method］ One hundred and fifty cases of different TCM syndrome of Bhepatocirrhosis were included in the study.The diameters and blood flow velocity of the portal vein were tested by color Doppler sonarography.And the TBIL，ALT，AST，ALB，GLB and PTA were tested.According to ChildPugh score,standard liver function was classified.［Results］ Diameter of the main portal vein in patients with internal accumulation of dampheat was significantly different to that of the hepatic and renal Yin deficiency，or the asthenic spleen and kidney Yang，or the blood stasis syndrome，respectively（Plt;0.05）.The blood flow velocities and flow volumes of portal vein with the blood stasis syndrome were significantly different to the stagnation of liver Qi （Plt;0.01）.Diameter of the portal vein in patients with different classification was expanded，and the blood flow velocity and flow volume of the portal vein were degraded.Liver functions in patients with the stagnation of liver Qi were of mainly A grade and significantly different to other syndromes （Plt;0.05）.The hepatic and renal Yin deficiency，the asthenia splenonephroYang，and the blood stasis syndrome were of mainly C grade and significantly different to the other 3 syndromes （Plt;0.05）.［Conclusion］ The stagnation of liver Qi and internal accumulation of