王文川 殷建敏

【摘要】目的：探討彩色多普勒超声检查参数与非酒精性脂肪肝患者肝功能的关系及临床价值。方法：回顾性选取2019年10月—2022年1月我院150例非酒精性脂肪肝患者的临床资料设为研究组，另选取150例同期健康体检者的临床资料设为对照组。两组研究对象均接受彩色多普勒超声检查，并抽取血液样本检测肝功能相关指标，统计对照组与研究组不同病情程度患者多普勒频谱特征、超声检查血流参数[肝动脉阻力指数（HARI）、门静脉最大血流速度（PPVV）、平均速度（MPVV）]、肝功能指标[γ-谷氨酰转肽酶（GGT）、天冬氨酸转氨酶（AST）、丙氨酸氨基转移酶（ALT）]水平，并统计分析研究组超声检查血流参数与肝功能的关联性。结果 对照组与研究组不同病情程度非酒精性脂肪肝患者多普勒频谱特征相比，差异有统计学意义（P<0.05），且研究组随着病情程度的加剧，正常型比例呈持续下降趋势（P<0.05）；对照组与研究组不同病情程度非酒精性脂肪肝患者HARI、PPVV、MPVV及GGT、AST、ALT水平间差异显著（P<0.05），且研究组随着病情程度的加剧，HARI、PPVV、MPVV呈持续下降趋势，GGT、AST、ALT水平呈持续增高趋势（P<0.05）；非酒精性脂肪肝患者彩色多普勒超声检查参数HARI、PPVV、MPVV与肝功能指标GGT、AST、ALT间存在显著负相关关系（P<0.05）。结论 非酒精性脂肪肝患者经彩色多普勒超声检查可见血流动力学等异常，能有效反映肝脏脂肪的变性状况，且彩色多普勒超声相关参数与肝功能具有密切关联性，能用于肝功能的评估。

【关键词】非酒精性脂肪肝；彩色多普勒超声；肝功能

基金项目：河北省中医药管理局科研计划项目《荷叶调脂疏肝汤治疗糖耐量异常并非酒精性脂肪肝的临床探究》（2019511）

Relationship between parameters of color doppler ultrasonography and liver function in patients with nonalcoholic fatty liver disease and its clinical value

WANG Wenchuan1， YIN Jianmin2

1.Department of Hepatology， Xingtai Peoples Hospital affiliated to Hebei Medical University， Xingtai， Hebei 054000， China；2.Department of Ultrasound， Xingtai Peoples Hospital affiliated to Hebei Medical University， Xingtai， Hebei 054000， China

【Abstract】Objective： To explore the relationship between color Doppler ultrasound parameters and liver function in patients with nonalcoholic fatty liver disease and its clinical value. Methods： a retrospective selection in October 2019 to January 2022 our hospital clinical data of 150 patients with nonalcoholic fatty liver disease is set to the team， the other to select the clinical data of 150 cases of healthy physical examination over the same set as control group. Both groups were examined by color doppler ultrasound， liver function and draw blood samples related indicators， Doppler spectrum characteristics， ultrasound blood flow parameters [hepatic artery resistance index （HARI）， maximum portal vein blood flow velocity （PPVV）， average velocity （MPVV）]， liver function indexes [γ-glutamyl transpeptidase （GGT）， aspartate aminotransferase （AST）， alanine aminotransferase （AL）] of patients with different severity of disease in the control group and the study group were analyzed T）]， and the correlation between ultrasound blood flow parameters and liver function in the study group was statistically analyzed. Results：In the control group and the group at the different degree of disease in patients with nonalcoholic fatty liver disease than doppler spectrum characteristics， the difference was statistically significant （P<0.05）， and the team since the degree of illness， normal type ratio showed a trend of declining （P<0.05）； There were significant differences in HARI， PPVV， MPVV， GGT， AST， and ALT levels between the control group and the study group with different disease severity （P<0.05）， and HARI， PPVV， and MPVV showed a continuous downward trend with the aggravation of disease severity in the study group. The levels of GGT， AST and ALT showed a continuous increase trend （P<0.05）. Nonalcoholic fatty liver disease patients with color doppler ultrasound parameters HARI， PPVV， MPVV and liver function index GGT， there is a significant negative correlation relationship between the AST， ALT （P<0.05）. Conclusion：Patients with nonalcoholic fatty liver disease by color doppler ultrasound visible hemodynamic abnormalities， such as can effectively reflect the status of the degeneration of liver fat， and related parameters of color doppler ultrasound is a close correlation with liver function， can be used for the assessment of liver function.

【Key Words】Nonalcoholic fatty liver disease； Color doppler ultrasound； Liver function

非酒精性脂肪肝为临床多发肝脏疾病类型，主要是诸多因素致使肝脏细胞中脂肪过度堆积所引发的疾病，为隐蔽性肝硬化的重要诱因[1]。同时，近年来，受不良生活习惯养成及膳食结构转变等诸多因素影响，我国非酒精性脂肪肝发病率仍呈逐年增高趋势，且若非酒精性脂肪肝患者未得到及时有效干预，则随病情进展可引发肝硬化、肝癌等，故早期对非酒精性脂肪肝进行准确的诊断评估对保证疾病良好转归具有重要意义[2-3]。……