Digestive Disease Research Center, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Eur J Gastroenterol Hepatol. 2011 Apr;23(4):354-8. doi: 10.1097/MEG.0b013e3283451e7d.
Although for asymptomatic hepatic hemangiomas conservative management is generally recommended, factors affecting the disease course are still not very well understood.
To determine disease characteristics of cavernous hemangioma and factors affecting its progression in patients from a general hepatology clinic in Tehran, Iran.
We reviewed medical records of 198 patients with cavernous hemangioma of the liver visiting a large private hepatology clinic in Tehran from 1997 to 2007. Of a total of 198 cases, 129 could be followed up for a period of 3.2 ± 2.5 years, and 80 of these had 1-5 repeated sonographies.
Patients were between 27 and 84 years old (mean age: 44.3 ± 10.9 years), and 131 (66.2%) were female. Thirty-six patients (18.2%) had giant hemangiomas. Abdominal pain was the primary reason for evaluation in 100 (50.5%) patients. Abdominal pain at the beginning of the follow-up was significantly associated with having irritable bowel syndrome [odds ratio (OR)=8.3; 95% confidence interval (CI): 3.1-28.7] or other gastrointestinal diseases (OR=3.9; 95% CI: 2.6-10.2), but not with hemangioma size, number, or location. During follow-up, having a single giant lesion at the time of diagnosis, adjusted for age, sex, and presence of irritable bowel syndrome, was a strong predictor of persistent pain during follow-up (OR=11.1; 95% CI: 3.2-38.6). In repeated sonographies, 35% showed an increased size, which was significantly associated only with having a single lesion (P=0.04).
Many symptoms in hepatic hemangioma are attributable to accompanying gastrointestinal diseases. Patients with a single giant lesion are more likely to have persistent pain, and single lesions are more likely to grow in size.
尽管对于无症状性肝血管瘤一般推荐保守治疗，但影响疾病进程的因素仍不是非常清楚。
在伊朗德黑兰的一个普通肝脏病学诊所，确定海绵状血管瘤的疾病特征及其进展的影响因素。
我们回顾了 1997 年至 2007 年期间在德黑兰的一家大型私立肝脏病学诊所就诊的 198 例肝海绵状血管瘤患者的病历。总共 198 例患者中，有 129 例可随访 3.2±2.5 年，其中 80 例有 1-5 次重复超声检查。
患者年龄为 27 至 84 岁（平均年龄：44.3±10.9 岁），131 例（66.2%）为女性。36 例（18.2%）为巨大血管瘤。100 例（50.5%）患者因腹痛就诊。在随访开始时出现腹痛与患有肠易激综合征[比值比（OR）=8.3；95%置信区间（CI）：3.1-28.7]或其他胃肠道疾病显著相关（OR=3.9；95% CI：2.6-10.2），但与血管瘤大小、数量或位置无关。在随访期间，对于调整年龄、性别和肠易激综合征存在的情况下，诊断时存在单个巨大病变是随访期间持续疼痛的强烈预测因素（OR=11.1；95% CI：3.2-38.6）。在重复超声检查中，35%显示病变增大，仅与存在单个病变显著相关（P=0.04）。
许多肝血管瘤的症状归因于伴随的胃肠道疾病。有单个巨大病变的患者更有可能持续疼痛，并且单个病变更有可能增大。
