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布加综合征的生存及预后指标:79项研究的系统评价

Survival and prognostic indicators of Budd-Chiari syndrome: a systematic review of 79 studies.

作者信息

Qi Xingshun, Ren Weirong, Wang Yongji, Guo Xiaozhong, Fan Daiming

机构信息

Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, China.

出版信息

Expert Rev Gastroenterol Hepatol. 2015 Jun;9(6):865-75. doi: 10.1586/17474124.2015.1024224. Epub 2015 Mar 10.

Abstract

This paper aimed to systematically review the survival of Budd-Chiari syndrome and to identify the most robust prognostic predictors. Overall, 79 studies were included. According to the treatment modalities, the median 1-, 5- and 10-year survival rate was 93, 83 and 73% after interventional radiological treatment; 81, 75 and 72.5% after surgery other than liver transplantation; 82.5, 70.2 and 66.5% after liver transplantation and 68.1, 44.4% and unavailable after medical therapy alone. According to the publication years, the median 1-, 5- and 10-year survival rate was 68.6, 44.4% and unavailable before 1990; 75.1, 69.5 and 57% during the year 1991-1995; 77, 69.6 and 65.6% during the year 1996-2000; 86.5, 74 and 63.5% during the year 2001-2005 and 90, 82.5 and 72% after 2006. Bilirubin, creatinine and ascites were more frequently identified as significant prognostic factors in univariate analyses. But their statistical significance was less frequently achieved in multivariate analyses.

摘要

本文旨在系统评价布加综合征的生存率,并确定最可靠的预后预测因素。总体而言,共纳入79项研究。根据治疗方式,介入放射治疗后1年、5年和10年的中位生存率分别为93%、83%和73%;非肝移植手术治疗后分别为81%、75%和72.5%;肝移植后分别为82.5%、70.2%和66.5%;单纯药物治疗后分别为68.1%、44.4%,10年生存率未提及。根据发表年份,1990年前1年、5年和10年的中位生存率分别为68.6%、44.4%,10年生存率未提及;1991 - 1995年分别为75.1%、69.5%和57%;1996 - 2000年分别为77%、69.6%和65.6%;2001 - 2005年分别为86.5%、74%和63.5%;2006年后分别为90%、82.5%和72%。在单因素分析中,胆红素、肌酐和腹水更常被确定为显著的预后因素。但在多因素分析中,它们的统计学意义较难达到。

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