中国实用外科杂志2018，Vol.38Issue(2)：205-209,5.DOI:10.19538/j.cjps.issn1005-2208.2018.02.20
布-加综合征病人副肝静脉代偿情况及相关因素分析
Analysis of compensation and related factors of accessory hepatic veins in Budd-Chiari syndrome
摘要
Abstract
Objective To analyze the compensatory expansion of accessory hepatic vein(AHV) in patients with Budd-Chiari syndrome(B-CS),and to explore the possible factors and clinical significance of the expansion.Methods A retrospective analysis was conducted for the clinical data of 78 patients with B-CS in the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2016.The number and diameter of AHV were evaluated by color Doppler ultrasound.Two groups were divided according to the ultrasound results,the obviously compensatory expansion group (single maximum diameter ≥ 5 mm or total diameters ≥ 6 mm,n=58) and the non obviously compensatory expansion group (single maximum diameter ＜ 5 mm and total diameters ＜ 6 mm,n=20).The single diameter includes A type with diameter ≥ 5 mm and B type with diameter ＜ 5 mm.Patients' gender,age,type of B-CS,hepatic venous obstruction degree,prothrombin time (PT),Child-Pugh class,portal vein diameter,blood flow velocity of portal vein,the level of serum vascular endothelial growth factor (VEGF),D-Dimer,fibrinogen and the angle between all of AHV's major axis and inferior vena cava(IVC) in two group were recorded.Results Among the 78 patients of B-CS,68 patients (87.2％) had AHV.There were 124 AHV in total (A type 96,B type 28).There were significant differences in the type of disease [main hepatic vein(MHV) 3(5.％2) vs.1(5.0％),inferior vena cava (IVC) 0 vs.4(20.0),Mix 55(94.8)vs.15 (75.0),P=0.007],the degree of obstruction of the MHV [Ⅰ 0 vs.2 (10.0％),Ⅱ 0 vs.2 (10.0％),Ⅲ 6 (10.3％) vs.10 (50.0％),Ⅳ 52 (89.7％) vs.6 (30.0％),Z=-5.378,P=0.000] and serum VEGF level [(68.1±40.4)ng/L vs.(394.2±194.6) ng/L,t=-7.437,P=0.000] between two groups (P ＜ 0.05);There was no statistical significance in the gender (x2=0.027),age (t=0.960),PT (t=-0.020),Child-Pugh class (Z=-0.564),portal vein diameter (t=1.586),blood flow velocity of portal vein (t=0.154),serum D-Dimer level (t=0.166) and fibrinogen level (t=-1.562) between two group (P ＞ 0.05).The angle between accessory hepatic vein's major axis and IVC between two types of AHV had statistical significance (x2=15.827,P=0.000).The total diameter of AHV had a positive correlation with the obstructive degree of MHV (r=0.657,P=0.000),and had a negative correlation with the level of serum VEGF (r=-0.725,P=0.000).The obstructive degree of MHV had a negative correlation with the level of serum VEGF (r=-0.445,P=0.000),too.Conclusion Most of B-CS patients have the compensatory expansion of AHV,which is associated with the type of B-CS,the obstructive degree of MHV and the serum VEGF level,and might be related to the angle between accessory hepatic vein and IVC.关键词
副肝静脉/布-加综合征/代偿性扩张Key words
accessory hepatic vein/Budd-Chiari syndrome/compensatory expansion分类
医药卫生引用本文复制引用
党晓卫,付坤坤,李林,李路豪,刘优优,牛光辉,李松,张中杰,许培钦..布-加综合征病人副肝静脉代偿情况及相关因素分析[J].中国实用外科杂志,2018,38(2):205-209,5.基金项目
河南省科技厅资助项目(No.132102310424) （No.132102310424）
