本文選題：彩色多普勒 + 超聲��； 參考：《大連醫(yī)科大學(xué)》2014年碩士論文

【摘要】：第一部分 彩色多普勒超聲對(duì)慢性肝纖維化疾病的評(píng)價(jià) 目的：探討彩色多普勒超聲對(duì)慢性肝纖維化疾病的診斷價(jià)值。 方法：選擇180例慢性乙型肝炎患者作為研究對(duì)象，按肝活檢病理診斷肝纖維化分級(jí)進(jìn)行分組：0級(jí)(S0)40例，1級(jí)(S1)38例，2級(jí)(S2)37例，3級(jí)(S3)40例，4級(jí)(S4)35例。應(yīng)用彩色多普勒超聲獲得下列參數(shù)：門靜脈主干內(nèi)徑(mPVD)、門靜脈主干血流平均速度(mPVm)、門靜脈血流量（mPBF）、門靜脈淤血指數(shù)（CI）、脾靜脈內(nèi)徑（SVD）、脾靜脈平均血流速度（sVm）、脾靜脈血流量（sVBF）。結(jié)果同肝組織活檢的病理纖維化分期進(jìn)行相關(guān)性研究。 結(jié)果：門靜脈主干內(nèi)徑(mPVD)、門靜脈主干血流平均速度(mPVm)、門靜脈淤血指數(shù)(CI)和脾靜脈內(nèi)徑(sVD)在肝纖維化分期各組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)，，兩兩比較均具有明顯差異（P均0.05)。門靜脈主干內(nèi)徑、脾靜脈內(nèi)徑、門靜脈的淤血指數(shù)與肝纖維化分期呈正相關(guān)關(guān)系(r=0.44，0.41，0.42，P均0.05)。門靜脈的平均流速與肝纖維化分期呈負(fù)相關(guān)關(guān)系（r=-0.43，P 0.05）。 結(jié)論：彩色多普勒超聲作為一項(xiàng)常規(guī)的超聲技術(shù)，獲得的門靜脈及脾靜脈的相關(guān)參數(shù)對(duì)于肝纖維化的判定具有一定的診斷價(jià)值。 第二部分 FibroScan技術(shù)對(duì)慢性肝纖維化疾病的評(píng)價(jià) 目的：探討應(yīng)用FibroScan技術(shù)評(píng)價(jià)慢性乙型肝炎及肝硬化患者肝纖維化程度的價(jià)值。 方法：選擇各類慢性肝病患者360例作為研究對(duì)象，其中分為乙型肝炎病毒攜帶者組（112例），慢性乙型肝炎組（130例）、肝硬化組（118例）。應(yīng)用FibroScan技術(shù)獲得肝臟瞬時(shí)彈性硬度測(cè)定值（FibroScan值，F(xiàn)S值）(單位kPa)，各組間進(jìn)行比較。 結(jié)果：各組間FS值比較差異有統(tǒng)計(jì)學(xué)意義(P 0.05)，兩兩比較結(jié)果：CHB組乙肝病毒攜帶者組(P 0.05)，肝硬化組乙肝病毒攜帶者組(P 0.05)，肝硬化組CHB患者組(P 0.05)。 結(jié)論：FibroScan技術(shù)可以較為準(zhǔn)確地評(píng)價(jià)慢性肝病患者的肝臟纖維化程度，對(duì)于肝纖維化的早期診斷及治療具有重要的臨床意義。
[Abstract]:Part one Evaluation of chronic Hepatic Fibrosis by Color Doppler Ultrasound Objective: to evaluate the diagnostic value of color Doppler ultrasound in chronic hepatic fibrosis. Methods: one hundred and eighty patients with chronic hepatitis B were divided into 40 cases of grade 1 S1 and 38 cases of grade 2 S2P, 37 cases of grade 3 of S3 and 40 cases of grade 4 of S4N according to liver biopsy and pathological diagnosis of hepatic fibrosis grade (n = 40, n = 40, n = 40, n = 40, n = 40, n = 35, n = 40, n = 40, n = 40, n = 40, n = 40, n = 40). The following parameters were obtained by color Doppler ultrasound: the main portal vein diameter (PVD), the mean velocity of portal vein blood flow (MPVM), the portal vein blood flow (PVF), the portal vein blood flow (PVF), the portal vein congestion index (PVP), the diameter of the splenic vein (SVD), the mean velocity of the splenic vein (SVV), and the splenic venous blood flow (sVBFV). Results correlation study was carried out with pathological fibrosis stage of liver biopsy. Results: there were significant differences in the diameter of the main portal vein (MPVD), the mean velocity of portal vein blood flow (MPVM), the portal vein congestion index (CI) and the splenic vein diameter (sVD) in hepatic fibrosis stages (P 0.05), and there were significant differences between the two groups (P < 0.05). The diameter of the main portal vein, the internal diameter of the splenic vein and the blood stasis index of the portal vein were positively correlated with the stage of hepatic fibrosis. There was a negative correlation between the mean velocity of portal vein and the stage of hepatic fibrosis. Conclusion: as a conventional ultrasound technique, the parameters of portal vein and splenic vein obtained by color Doppler ultrasound have certain diagnostic value for hepatic fibrosis. Part two Evaluation of chronic hepatic fibrosis by FibroScan Objective: to evaluate the value of FibroScan in evaluating the degree of hepatic fibrosis in patients with chronic hepatitis B and liver cirrhosis. Methods: 360 patients with chronic liver disease were divided into three groups: hepatitis B virus carrier group (112 cases), chronic hepatitis B group (130 cases) and cirrhosis group (118 cases). The FibroScan technique was used to determine the instantaneous elastic hardness of the liver and to compare the values of FibroScan and FS (unit KPA) among the groups. Results: there were significant differences in FS values among the groups (P 0.05). The results showed that there was no significant difference between the two groups in the hepatitis B virus carriers group (P 0.05), the liver cirrhosis group (P 0.05) and the cirrhosis group (CHB) group (P 0.05). Conclusion the technique of: FibroScan can accurately evaluate the degree of hepatic fibrosis in patients with chronic liver disease and has important clinical significance for the early diagnosis and treatment of liver fibrosis.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.1;R575.2

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