A Preliminary Study Of Hemodynamics And Gastric Dynamics In Patients With Nonalcoholic Fatty Liver By Ultrasonography

Objective:1.To investigate the difference of liver hemodynamics between patients with nonalcoholic fatt y liver disease（NAFLD）and healthy people.2.To investigate the differences in gastric dynamics between NAFLD patients and healthy people.3.To investigate the differences of gastric dynamics and liver hemodynamics in patients with different degrees of NAFLD.Data and methods:90 patients with fatt y liver were admitted to our hospital from August 2019 to December 2020,including 30 patients with mild fatt y liver,30 patients with moderate fatt y liver and 30 patients with severe fatt y liver.Thirty healthy subjects in our hospital during the same period were selected as control group.All sub jects underwent laboratory examination,gastroscopy and 13C air blowing test,except gastric and duodenal ulcers,erosion,tumors,pancreatic and gallbladder lesions and other liver diseases,and had no history of alcohol abuse.None of the subjects had a history of abdominal surgery.The subjects did not take any drugs that affected gastrointestinal motionwithin 1 week.Acuson X 300 color Doppler ultrasound diagnostic instrument with probe frequency of 3.5-5.0MHz was used.Fasting 12 h,the experimental group and control group in both lie to ultrasound examination,measurement of portal vein and hepatic artery blood flow resistance index and fasting gallbladder volume,with a position measuring 3 times,average,probe placed under xiphoid process on the right side,vertical scan in a row,with the distal oval,confirm the state of the stomach is empt y,measuring the distal area on an empt y stomach.Ask the examiner to sit and drink 500ml warm water as soon as possible within 2 minutes,and start the examination immediatel y at 45°from the second half of the decubitus.The single-section method of gastric antrum area was used for sampling,and the gastric antrum body surface of the subjects was marked.The gastric antrum area of each subject was measured at four ti me points,namel y,immediatel y after drinking water,10min,15min and 20min.The gastric empt ying rate at 10min,15min and 20min after drinking water was calculated by taking the average value for 3 times at each time point.The movement frequency of gastric antrum within-10min immediatel y after drinking water was recorded,and the average value of 2 minutes was taken.The volume of the gallbladder was repeatedl y measured in the decubitus position 20 minutes after drinking water.The volume of the gallbladder was measured for 3 times in the same position.The mean value was taken and the gallbladder shrinkage rate was calculated.Results:Comparison among the control group,mild group,moderate group and severe group showed that Fgastric movement frequency=56.63,F10-minute gastric emptying rate=53.94,F15-minute gastric emptying rate=490.59,F20-minute gastric emptying rate=528.67,Fgallbladder _{c o n t r a c t i o n r a t e}=100.45,F_PPVV=66.95,and F_HARI=33.29,all P<0.01.Comparison between two groups showed all P<0.01.There was a statisticall y significant difference.This indicates that the frequency of gastric movement,gastric emptied frequency,gallbladder shrinkage,PPVV and HARI are related to fatt y liver,and graduall y decrease or decrease with the severit y of fatt y liver.Fasting gastric antrum area,gastric antrum area immediatel y after drinking water,and fasting gallbladder area（P>0.05）showed no statistical significance.Fasting gastric antrum area,gallbladder area and gastric antrum area immediatel y after drinking water had no correlation with the severit y of fatt y liver disease and whether there was fatt y liver.Conclusion:1.Two-dimensional ultrasound can clearly detect the dynamic situation of gastric motilit y,which is a simple,non-invasive and repe atable diagnostic method.2,color doppler flow imaging（cdfi）in NAFLD hemodynamic parameters related to detection,can directl y reflect the degree of fatt y infiltration of NAFLD,namel y PPVV blood flow velocit y,the slower the HARI numerical value is low er,the more severe liver fatt y infiltration degree and the consistency with the results of clinical diagnosis and the development of the course has,for the auxiliary diagnosis of NAFLD has higher reference value.3.Ultrasonic detection of gastric motili ty can directl y reflect the gastric motilit y of NAFLD,that is,the more serious the degree of liver fat infiltration,the more obvious the decline of gastric motilit y..4,The results of ultrasonic detection of gallbladder contraction rate can indicate that the more serious the degree of liver fat infiltration is,the more obvious the decrease of gallbladder contraction rate is.