Li Gangping, Huang Ying, Tang Shunyu, Song Yuhu, Liang Huimin, Liu Dehan, Yang Ling, Hou Xiaohua
1 Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
2 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Vascular. 2018 Feb;26(1):80-89. doi: 10.1177/1708538117718638. Epub 2017 Jul 25.
Background The characteristics and prevalence of Budd-Chiari syndrome in China remain unclear. This study aimed to analyze the clinical features of Budd-Chiari syndrome in Chinese patients in the Hubei area. Methods One-hundred and thirty patients with Budd-Chiari syndrome, admitted to Union Hospital from January 2002 to January 2011, were included in this retrospective study. Clinical features, laboratory data, imaging characteristics, and cumulative patency rates were analyzed. Results Of the 130 patients with Budd-Chiari syndrome, 77 were men (59.2%) and 53 women (40.8%). Budd-Chiari syndrome was more commonly associated with inferior vena cava block (56.9%, 74/130) than hepatic vein block (19.2%, 25/130) and combined inferior vena cava/hepatic vein block (23.9%, 31/130). The clinical features of Budd-Chiari syndrome varied based on the location of the obstruction. The incidence of bilirubin abnormality, elevated alkaline phosphatase, and γ-glutamyl peptide transferase levels was common in patients with Budd-Chiari syndrome. Liver injury was more severe in cases with combined inferior vena cava/hepatic vein block than in the other two types of Budd-Chiari syndrome. Color Doppler ultrasound imaging was better for the diagnosis of hepatic vein obstruction, while computed tomography and magnetic resonance imaging were superior in diagnosing inferior vena cava obstruction. The cumulative 1-, 5-, and 10-year patency rates were 97%, 69%, and 59%, respectively. Univariate analysis indicated that liver cirrhosis was an independent risk factor of recurrence. Conclusion The most prevalent type of Budd-Chiari syndrome is inferior vena cava obstruction in Chinese patients in the Hubei area. Different types of Budd-Chiari syndrome have diverse clinical and biochemical features, which may assist clinicians in diagnosing Budd-Chiari syndrome. Liver cirrhosis was found as an independent risk factor of recurrence.
布加综合征在中国的特征及患病率尚不清楚。本研究旨在分析湖北地区中国患者布加综合征的临床特征。方法：本回顾性研究纳入了2002年1月至2011年1月在协和医院收治的130例布加综合征患者。分析其临床特征、实验室数据、影像学特征及累积通畅率。结果：130例布加综合征患者中，男性77例（59.2%），女性53例（40.8%）。布加综合征与下腔静脉阻塞（56.9%，74/130）的关联比肝静脉阻塞（19.2%，25/130）及下腔静脉/肝静脉联合阻塞（23.9%，31/130）更为常见。布加综合征的临床特征因梗阻部位而异。布加综合征患者胆红素异常、碱性磷酸酶及γ-谷氨酰肽转移酶水平升高的发生率常见。下腔静脉/肝静脉联合阻塞病例的肝损伤比其他两种类型的布加综合征更严重。彩色多普勒超声成像对肝静脉阻塞的诊断较好，而计算机断层扫描和磁共振成像在诊断下腔静脉阻塞方面更具优势。累积1年、5年和10年通畅率分别为97%、69%和59%。单因素分析表明肝硬化是复发的独立危险因素。结论：在湖北地区的中国患者中，布加综合征最常见的类型是下腔静脉阻塞。不同类型的布加综合征具有不同的临床和生化特征，这可能有助于临床医生诊断布加综合征。发现肝硬化是复发的独立危险因素。
