彩色多普勒超声对诊断感染致婴儿肝炎综合征的价值分析
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摘要
目的探讨彩色多普勒超声对诊断感染致婴儿肝炎综合征的价值,为临床诊断提供参考。方法选择医院2012年2月-2016年7月收治的感染致婴儿肝炎综合征患儿62例为研究对象,设为观察组,另选30名进行健康体检的婴儿为对照组,两组婴儿均进行彩色多普勒超声检查,对比分析两组婴儿门静脉(PV)血流参数、肝动脉(HA)血流参数及肝左、肝中和肝右静脉血管的直径情况。结果观察组PV主干血管直径(DPV)为(0.52±0.03)cm、最大血流速(PVV)为(25.32±2.06)cm/s,均大于对照组(0.43±0.04)cm、(21.56±1.75)cm/s,结果表明,感染致婴儿肝炎综合征患儿与正常婴儿相比,其DPV会增大,PVV更快,两组间差异有统计学意义(P<0.05);观察组肝动脉血管直径(DPHA)为(0.16±0.03)cm、收缩期峰值血流速(PSV)为(62.50±9.61)cm/s、阻力指数(RI)为0.78±0.04,明显大于对照组(0.14±0.02)cm、(39.91±5.79)cm/s、0.64±0.03,结果表明,感染致婴儿肝炎综合征患儿与正常婴儿相比,其DPHA和RI会增大,PSV会加快,差异有统计学意义(t=3.3083,11.8561,16.9796,P<0.05);两组舒张期血流速(EDV)差异无统计学意义(t=1.2806,0.2036);观察组肝左、肝中和肝右静脉血管直径分别为(0.19±0.01)cm、(0.20±0.03)cm、(0.23±0.03)cm与对照组(0.25±0.04)cm、(0.29±0.02)cm、(0.32±0.03)cm相比明显更低,表明感染致婴儿肝炎综合征患儿与正常婴儿相比,其肝左、肝中和肝右静脉血管直径会明显变小,两组间差异有统计学意义(P<0.05)。结论通过彩色多普勒超声,能较清晰的反映患儿肝炎综合征情况,是一种高效、无创的诊断感染致婴儿肝炎综合征的方法,其临床信息丰富,应用价值较高,值得推广。
OBJECTIVE To investigate the value of color Doppler ultrasound in the diagnosis of infantile hepatitis syndrome caused by infection,so as to provide guidances for clinical diagnosis.METHODS A total of 62 infected patients with infantile hepatitis syndrome in the hospital from Feb.2012 to Jul.2016 were selected as research objects,and were set as observation group.Another 30 cases of healthy infants were selected as control group.Two groups of infants were examined by color Doppler ultrasound.The blood flow parameters of the portal vein(PV),the parameters of the hepatic artery(HA)and the diameters of the left,middle and right hepatic veins were compared.RESULTS The vascular PV trunk diameter(DPV)and the maximum blood flow velocity(PVV)of observation group were(0.52±0.03)cm and(25.32±2.06)cm/s,which were higher than(0.43±0.04)cm and(21.56±1.75)cm/s of control group respectively.The results showed that,compared with the normal infants,the DPV increased,and PVV was faster in the infants with the infantile hepatitis syndrome caused by infection,and the difference between the two groups was statistical significance(P<0.05).In observation group,the liver artery diameter(DPHA)was(0.16±0.03)cm,peak systolic blood flow velocity(PSV)was(62.50±9.61)cm/s,and resistance index(RI)was(0.78±0.04),which were significantly higher than(0.14±0.02)cm,(39.91±5.79)cm/s,and(0.64±0.03)of control group the results showed that compared with normal infants,DPHA and RI increased,and PSV was faster in the infants with the infantile hepatitis syndrome caused by infection,and the difference between the two groups was statistical significance(t=3.3083,11.8561,16.9796,P<0.05).There was no significant difference in diastolic blood flow(EDV)between the two groups(t=1.2806,0.2036).In observation group,the diameters of the left,middle and right hepatic veins were(0.19 + 0.01)cm,(0.20±0.03)cm,and(0.23±0.03)cm,which were obviously lower than(0.25± 0.04)cm,(0.29±0.02)cm,and(0.32±0.03)cm of control group respectively.The results showed that compared with normal infants,the diameters of the left,middle and right hepatic veins were significantly smaller in the infants with the infantile hepatitis syndrome caused by infection,and the difference between the two groups was statistical significance(P<0.05).CONCLUSIONColor Doppler ultrasound can clearly relate with the hepatitis syndrome conditions of patients,which is an effective and noninvasive method for the diagnosis of infantile hepatitis syndrome caused by infection,and the clinical information is comprehensize,the application value is high,and it is worthy of popularization.
OBJECTIVE To investigate the value of color Doppler ultrasound in the diagnosis of infantile hepatitis syndrome caused by infection,so as to provide guidances for clinical diagnosis.METHODS A total of 62 infected patients with infantile hepatitis syndrome in the hospital from Feb.2012 to Jul.2016 were selected as research objects,and were set as observation group.Another 30 cases of healthy infants were selected as control group.Two groups of infants were examined by color Doppler ultrasound.The blood flow parameters of the portal vein(PV),the parameters of the hepatic artery(HA)and the diameters of the left,middle and right hepatic veins were compared.RESULTS The vascular PV trunk diameter(DPV)and the maximum blood flow velocity(PVV)of observation group were(0.52±0.03)cm and(25.32±2.06)cm/s,which were higher than(0.43±0.04)cm and(21.56±1.75)cm/s of control group respectively.The results showed that,compared with the normal infants,the DPV increased,and PVV was faster in the infants with the infantile hepatitis syndrome caused by infection,and the difference between the two groups was statistical significance(P<0.05).In observation group,the liver artery diameter(DPHA)was(0.16±0.03)cm,peak systolic blood flow velocity(PSV)was(62.50±9.61)cm/s,and resistance index(RI)was(0.78±0.04),which were significantly higher than(0.14±0.02)cm,(39.91±5.79)cm/s,and(0.64±0.03)of control group the results showed that compared with normal infants,DPHA and RI increased,and PSV was faster in the infants with the infantile hepatitis syndrome caused by infection,and the difference between the two groups was statistical significance(t=3.3083,11.8561,16.9796,P<0.05).There was no significant difference in diastolic blood flow(EDV)between the two groups(t=1.2806,0.2036).In observation group,the diameters of the left,middle and right hepatic veins were(0.19 + 0.01)cm,(0.20±0.03)cm,and(0.23±0.03)cm,which were obviously lower than(0.25± 0.04)cm,(0.29±0.02)cm,and(0.32±0.03)cm of control group respectively.The results showed that compared with normal infants,the diameters of the left,middle and right hepatic veins were significantly smaller in the infants with the infantile hepatitis syndrome caused by infection,and the difference between the two groups was statistical significance(P<0.05).CONCLUSIONColor Doppler ultrasound can clearly relate with the hepatitis syndrome conditions of patients,which is an effective and noninvasive method for the diagnosis of infantile hepatitis syndrome caused by infection,and the clinical information is comprehensize,the application value is high,and it is worthy of popularization.
引文
[1]亓培君,崔建华,王兴田,等.彩色多普勒超声诊断感染致婴儿肝炎综合征临床价值研究[J].中国校医,2010,24(9):662-665.
[2]王丽,钱继红,张拥军,等.人巨细胞病毒肝炎综合征婴儿外周血宿主microRNA表达的变化[J].中华实用儿科临床杂志,2013,28(10):737-740.
[3]世锁,杨秀珍,蒋玉麟.婴儿肝炎综合征71例临床分析[J].安徽医学,2014,2(4):279-281.
[4]廖勇,程建.婴儿肝炎综合征中巨细胞病毒感染率分析[J].中国社区医师,2016,32(9):133-133.
[5]孙梅,毛志芹,袁壮.婴儿巨细胞病毒感染的诊治[J].中国实用儿科杂志,2013,16(8):462-463.
[6]剧红娟,王秀丽,李英超,等.高频彩色多普勒超声对胆道闭锁的诊断价值[J].河北医科大学学报,2015,36(7):796-799.
[7]Richter S,Vollmar B,Mucke I,et al.Hepatic arteriolo portal venular shunting guarantees maintenance of nutritional micro vascular supply in hepatic arterial buffer response of rat livers[J].J Physiol,2014,16(4):291-295.
[8]Whitley RJ,Cloud G,Gruber W,et al.Ganciclovir treatment of symptomatic congenital cytomegalovirus infection:results of a phase II study.national institute of allergy and infectious diseases collaborative antiviral study group[J].J Infect Dis,1997,175(5):1080-1086.
[9]Tsutsui H,Adachi K,Seki E,et al.Cytokine induced inflammatory liver injuries[J].Curr Molecul Med,2014,19(5):424-428.
[10]Schneider E,Tonanny MB,Lisbonne M,et al.Pro-Th1cytokines promote Fas-dependent apoptosis of immature peripheral basophils[J].J Immunol,2004,172(9):5262-5268.
[11]Michaelis M,Baumgarten P,Mittelbronn M,et al.Oncomodulation by human cytomegalovirus:novel clinical findings open new roads[J].Med Microbiol Immunol,2011,200(1):1-5.
[12]von Herbay A,Frieling T,Haussinger D.Association between duplex Doppler sonographic flow pattern in right hepatic vein and various liver diseases[J].J Clin Ultrasound,2001,29(1):25-30.
[13]Jequier S,Jequier JC,Hanquinet S,et al.Hepatic vein Doppler studies:variability of flow pattern in normal children[J].Pediatr Radiol,2002,32(1):49-55.
[2]王丽,钱继红,张拥军,等.人巨细胞病毒肝炎综合征婴儿外周血宿主microRNA表达的变化[J].中华实用儿科临床杂志,2013,28(10):737-740.
[3]世锁,杨秀珍,蒋玉麟.婴儿肝炎综合征71例临床分析[J].安徽医学,2014,2(4):279-281.
[4]廖勇,程建.婴儿肝炎综合征中巨细胞病毒感染率分析[J].中国社区医师,2016,32(9):133-133.
[5]孙梅,毛志芹,袁壮.婴儿巨细胞病毒感染的诊治[J].中国实用儿科杂志,2013,16(8):462-463.
[6]剧红娟,王秀丽,李英超,等.高频彩色多普勒超声对胆道闭锁的诊断价值[J].河北医科大学学报,2015,36(7):796-799.
[7]Richter S,Vollmar B,Mucke I,et al.Hepatic arteriolo portal venular shunting guarantees maintenance of nutritional micro vascular supply in hepatic arterial buffer response of rat livers[J].J Physiol,2014,16(4):291-295.
[8]Whitley RJ,Cloud G,Gruber W,et al.Ganciclovir treatment of symptomatic congenital cytomegalovirus infection:results of a phase II study.national institute of allergy and infectious diseases collaborative antiviral study group[J].J Infect Dis,1997,175(5):1080-1086.
[9]Tsutsui H,Adachi K,Seki E,et al.Cytokine induced inflammatory liver injuries[J].Curr Molecul Med,2014,19(5):424-428.
[10]Schneider E,Tonanny MB,Lisbonne M,et al.Pro-Th1cytokines promote Fas-dependent apoptosis of immature peripheral basophils[J].J Immunol,2004,172(9):5262-5268.
[11]Michaelis M,Baumgarten P,Mittelbronn M,et al.Oncomodulation by human cytomegalovirus:novel clinical findings open new roads[J].Med Microbiol Immunol,2011,200(1):1-5.
[12]von Herbay A,Frieling T,Haussinger D.Association between duplex Doppler sonographic flow pattern in right hepatic vein and various liver diseases[J].J Clin Ultrasound,2001,29(1):25-30.
[13]Jequier S,Jequier JC,Hanquinet S,et al.Hepatic vein Doppler studies:variability of flow pattern in normal children[J].Pediatr Radiol,2002,32(1):49-55.