【摘要】 目的　了解慢性肝炎患者肝组织纤维化程度与门静脉主干 (MPV)和脾静脉 (SPV)直径、脾脏大小及周围血细胞计数的关系。方法　 15 1例慢性肝炎患者行肝组织病理检查 ,并按肝组织纤维化分级分为S1～S4 组 ,B超测量MPV和SPV直径 ,以脾指数 (SPI)表示脾脏大小 ,常规方法检测外周血的白细胞数 (WBC)、红细胞数 (RBC)和血小板计数 (PLT) ,并比较各组患者上述几种指标的差异。结果　S3 组和S4 组患者MPV及SPV直径大于S1组 ,S1组MPV和SPV直径分别为 (11.89± 1.39)mm和 (5 .78± 1.33)mm ,S4 组为 (13.0 7± 1.2 3)mm和 (8.0± 1.8)mm ,SPI也由S1组 (17.5 8± 6 .2 4)cm2 逐渐高达S4 组的 (2 8.97± 11.6 3)cm2 。S1组至S4 组 ,RBC、WBC和PLT逐渐降低 ,S1组分别为 (4 .6 7± 0 .6 7)× 10 12 /L ,(5 .46± 1.6 3)× 10 9/L和 (174.5 3± 5 7.0 5 )× 10 9/L ,S4 组分别为 (4 .0 3± 0 .77)× 10 12/L ,(4 .0± 1.0 )× 10 9/L和 (89.2 4± 35 .72 )× 10 9/L。其中 ,S3 和S4 组三项指标均明显低于S1组。结论　随肝纤维化程度逐渐加重 ,慢性肝炎患者门静脉主干和脾静脉直径逐渐扩张 ,脾脏逐渐增大 ,外周血WBC、RBC和PLT数逐渐降低更多还原

【Abstract】 Objective To study the relationship between liver fibrosis stages and the diameters of main portal vein (MPV) and spleen vein (SPV), spleen indexes (SPI) and peripheral blood cell counts. Methods 151 patients with chronic viral hepatitis were divided into S 1 to S 4 4 groups according to liver fibrosis stages. The RBC, WBC and PLT counts were tested routinely. The MPV and SPV diameters and the sizes of spleen (SPI) were measured by ultrasonography. Results 1)The MPV and SPV diameters and SPI were (11.89 ±1.39 )mm, (5.78±1.33)mm and (17.58±6.24)cm 2 in group S 1; (12.22±1.19)mm, (6.25±1.28)mm and (17.68±6.92)cm 2 in group S 2; (12.43±1.26)mm, (7.03±1.54)mm and (22.01±8.26)cm 2 in groups S 3; (13.07±1.23)mm, (8.0±1.8)mm and (28.97±11.63)cm 2 in group S 4, respectively. Significant differences of the MPV and SPV diameters and SPI were found between group S 4 and group S 1( P < 0.05 ). group S 4 and group S 2( P < 0.05 ). The SPV diameter in group S 3 was significantly higher than that in group S 1( P <0.005). 2)The peripheral blood cell counts decreased gradually from group S 1 to group S 4. The RBC, WBC and PLT counts in group S 1 were (4.67±0.67)×10 12 /L, (5.46±1.63)×10 9 /L and (174.53±57.05)×10 9 /L, in group S 4 were (4.03±0.77)×10 12 /L, (4.0±1.0)×10 9 /L and (89.24 ±35.72 )×10 9 /L, respectively. The differences of the counts of WBC and PLT were significant between group S 4 and group S 1( P <0.05), group S 3 and group S 1( P <0.05). Comparing to the other groups, the RBC count in group S 4 was significantly decreased ( P <0.05).Conclusion With the progression of liver fibrosis, the MPV and SPV diameters and SPI increase, and the peripheral blood cell counts decreased gradually in patients with chronic viral hepatitis.更多还原