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The Study Based on the Relativity between Hepatic Artery to Vein Transit Time and Portal Hypertensive Gastropathy

Author: LeiZuo
Tutor: HuangFeiZhou
School: Central South University
Course: Clinical
Keywords: cirrhosis Portal hypertensive gastropathy hepaticartery to vein transit time contrast-enhanced ultrasound
CLC: R575
Type: Master's thesis
Year: 2013
Downloads: 6
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Abstract


objective:Investigate relativity between hepatic artery to vein transit time and Portal hypertensive gastropathy, To provide a basis for diagnose PHG and PHG hemorrhage, also assess severity of PHG in cirrhosis patients.Method:86study objects with cirrhosis patients underwent endoscopy, divide into PHG group and no-PHG group according to diagnostic code of PHG,than divide PHG group into two subgroups according to grade criteria of PHG, there are mild group and severe group; divide into haemorrhage group and non-hemorrhage group according to diagnosis of PHG hemorrhage. All of patients received Color Doppler ultrasound first to assess hemodynamics of left gastric vein, then injected the Eontrast agent SonoVue through the elbow vein by intravenous bolus injection, observed the Process of SonoVue appeared in the hepatic artery and hthepatic vein, HAAT and HVAT Was recorded, HA-VTT was counted, analyzed the hemodynamics of left gastric vein and HAAT> HVAT、HA-VTT of every groups,meanwhile analyzed relativity between hepatic artery to vein transit time and hemodynamics of left gastric vein by statistical method, P<0.05was considered significance.Results:1.HVAT and HA-VTT decreased significantly in PHG group compared with no-PHG group (P<0.05), HAAT showed no significant difference between two groups.2. HVAT and HA-VTT decreased significantly in severe PHG group compared with mild group (P<0.05), HAAT showed no significant difference between two groups.3. HVAT and HA-VTT decreased significantly in haemorrhage group compared with non-hemorrhage group (P<0.05), HAAT showed no significant difference between two groups.4. By using Spearman rank correlation analysis, HVAT and development of PHG is negative correlation (r=-0.437, P<0.05); HA-VTT and development of PHG is negative correlation (r=-0.588, P<0.05).5. HA-VTT≤8s as the diagnostic PHG of cirrhosis patients, the sensitivity, specificity, accuracy was80.4%、95.0%、75.4%respectively. HA-VTT≤6s as the diagnostic PHG hemorrhage of cirrhosis patients, the sensitivity, specificity, accuracy was100%、62.5%、62.5%respectively.6. There are differences of left gastric vein flow Direction between the no-PHG group、mild group and severe group (P<0.05), The ratio of hepatofugal flow in severe group was significantly more than that in mild group, the ratio of hepatofugal flow in mild group was significantly more than that in no-PHG group group (P<0.05).7. There are differences of left gastric vein flow rate between the no-PHG group、mild group and severe group (P<0.05), left gastric vein flow rate in three groups was compared LSD-t test, there were significantly differences among the groups (P<0.05).8. HA-VTT decreased significantly in patients with left gastric vein hepatofugal flow compared with in patients with left gastric vein hepatopetal flow (P<0.05).9. By using pearson rank correlation analysis, HA-VTT and left gastric vein flow rate is negative correlation (r=-0.841, P<0.05).Conclusion:1. The shorter the HA-VTT in cirrhosis patients, the morbidity of PHG will be higher, Meanwhile the severity of PHG will be more serious, also the hemorrhage of PHG will be more likely.2. When the HA-VTT≤8s, suggest the diagnosis of PHG in cirrhosis patients; When the HA-VTT≤6s, suggest the diagnosis of PHG hemorrhage in cirrhosis patients.3. contrast-enhanced ultrasound used to measure HA-VTT is a useful method of examination that has the virtue of non-invasive and exact and repeatability tests. To provide a basis for diagnose PHG and PHG hemorrhage, also assess severity of PHG in cirrhosis patients.

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CLC: > Medicine, health > Internal Medicine > Digestive and abdominal diseases > Liver and gall bladder disease
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