乙肝肝硬化中医证型与门静脉血流动力学及肝功能分级相关性研究

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1、乙肝肝硬化中医证型与门静脉血流动力学及肝功能分级相关性研究【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（P<0.05）；血瘀证门静脉血流流速和血流量

2、减低，与肝气郁结证比较有统计学意义（P<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（P<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（P<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］StudyonthecharacteristicsofdifferenttraditionalChinesemedicalsyndromeofB

3、hepatocirrhosisrelatingwithhemodynamicsoftheportalvein9andliverfunctionsclassification.［Method］OnehundredandfiftycasesofdifferentTCMsyndromeofBhepatocirrhosiswereincludedinthestudy.ThediametersandbloodflowvelocityoftheportalveinweretestedbycolorDopplersonarography.AndtheTBIL，ALT，AST，ALB

4、，GLBandPTAweretested.AccordingtoChildPughscore,standardliverfunctionwasclassified.［Results］DiameterofthemainportalveininpatientswithinternalaccumulationofdampheatwassignificantlydifferenttothatofthehepaticandrenalYindeficiency，ortheasthenicspleenandkidneyYang，orthebloodstasissyndrome，re

5、spectively（P<0.05）.ThebloodflowvelocitiesandflowvolumesofportalveinwiththebloodstasissyndromeweresignificantlydifferenttothestagnationofliverQi（P<0.01）.Diameteroftheportalveininpatientswithdifferentclassificationwasexpanded，andthebloodflowvelocityandflowvolumeoftheportalveinweredegr

6、aded.LiverfunctionsinpatientswiththestagnationofliverQiwereofmainlyAgradeandsignificantlydifferenttoothersyndromes（P<0.05）.ThehepaticandrenalYindeficiency，theastheniasplenonephroYang，andthebloodstasissyndromewereofmainlyCgradeandsignificantlydifferenttotheother3syndromes（P<0.05）.［C

7、onclusion］ThestagnationofliverQiand9internalaccumulationofdampheatwereinearlierperiodinBhepatocirrhosispatients，patient’sconditionswerelight.CourseofdiseasesinpatientswiththeasdthenicsplenonephroYang，andthebloodstasissyndromeswasgenerallong，thebloodflowvelocities