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目的探讨利用胆囊声像图变化来判断急性甲型肝炎患者的肝细胞损害程度。方法超声测量41例健康志愿者和33例急性甲型肝炎患者胆囊的长径和短径,以及急性肝炎患者胆囊壁的厚度,计算胆囊面积和胆囊壁厚-面积比;利用生化仪以速率法检测患者血清丙氨酸氨基转移酶(ALT);将肝炎组胆囊壁厚度、胆囊面积和胆囊壁厚-面积比分别与ALT值进行直线相关与回归分析比较。结果健康志愿组胆囊壁光整,壁厚为(0.11±0.07)cm,胆囊面积为(22.1±4.97)cm2。胆囊壁厚-面积比为(0.0095±0.0023)cm-1,ALT值为(23±11)IU/L。急性肝炎组的胆囊壁厚度为(0.82±0.22)cm,胆囊面积为(16.36±4.87)cm2,胆囊壁厚-面积比为(0.0517±0.0176)cm-1;ALT值为(1737.46±784.03)IU/L;以上参数(胆囊壁厚度、胆囊面积、胆囊壁厚-面积比、ALT值)与健康志愿组相应参数两两比较,差异具有显著性,P<0.05。急性肝炎组的ALT值与该组胆囊壁厚-面积比之间存在着直线回归和相关性,(Y=87.26+28477.79x,r=0.72,P<0.05);ALT值与胆囊壁厚度及胆囊面积之间无直线相关性。结论1.胆囊声像图的改变是可以反映ALT的高低,从而可间接反映肝脏实质细胞的损害程度,至少急性甲型肝炎患者如此;2.胆囊壁厚-面积比是判断肝细胞损害程度比较合适的超声观察指标。
Objective To investigate the changes of gallbladder sonography to determine the degree of hepatocellular damage in patients with acute hepatitis A. Methods The long diameter and short diameter of gallbladder in 41 healthy volunteers and 33 patients with acute hepatitis A were measured by ultrasound. The gallbladder wall area and gallbladder wall thickness - area ratio were calculated by using biochemical analyzer. Serum alanine aminotransferase (ALT) was detected in the patients. The gallbladder wall thickness, gallbladder area and gallbladder wall thickness-area ratio in the hepatitis group were respectively compared with the ALT values by linear regression and regression analysis. Results In the healthy volunteer group, the gallbladder wall was smooth, the wall thickness was (0.11 ± 0.07) cm and the gallbladder area was (22.1 ± 4.97) cm2. Gallbladder wall thickness-area ratio was (0.0095 ± 0.0023) cm-1, and ALT was (23 ± 11) IU / L. The gallbladder wall thickness was (0.82 ± 0.22) cm in acute hepatitis group, (16.36 ± 4.87) cm2 in gallbladder and 0.0517 ± 0.0176 cm-1 in gallbladder wall area, and the ALT value was (1737.46 ± 784.03) IU / L; The above parameters (gallbladder wall thickness, gallbladder area, gallbladder wall thickness - area ratio, ALT value) and healthy volunteers corresponding parameters pairwise comparison, the difference was significant, P <0.05. Acute hepatitis group ALT value and the group gallbladder wall thickness - area ratio exists between the linear regression and correlation (Y = 87.26 +28477.79x, r = 0.72, P <0.05); ALT value and gallbladder wall thickness and gallbladder There is no linear correlation between areas. Gallbladder sonography changes is to reflect the level of ALT, which indirectly reflects the extent of the damage of liver parenchymal cells, at least in patients with acute hepatitis A; 2 gallbladder wall thickness - area ratio is to determine the extent of damage compared to the liver cells Appropriate ultrasound observations.