中国布加综合征：单中心 30 年回顾性生存研究。
Budd-Chiari syndrome in China: A 30-year retrospective study on survival from a single center.
机构信息
Department of Interventional Radiology, Shenzhen People's Hospital, the Second Affiliated Hospital of Jinan University, Shenzhen 518020, Guangdong Province, China.
Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China.
出版信息
World J Gastroenterol. 2018 Mar 14;24(10):1134-1143. doi: 10.3748/wjg.v24.i10.1134.
AIM
To investigate 30-year treatment outcomes associated with Budd-Chiari syndrome (BCS) at a tertiary hospital in China.
METHODS
A total of 256 patients diagnosed with primary BCS at our tertiary hospital between November 1983 and September 2013 were followed and retrospectively studied. Cumulative survival rates and cumulative mortality rates of major causes were calculated by Kaplan-Meier analysis, and the independent predictors of survival were identified using a Cox regression model.
RESULTS
Thirty-four patients were untreated; however, 222 patients were treated by medicine, surgery, or interventional radiology. Forty-four patients were lost to follow-up; however, 212 patients were followed, 67 of whom died. The symptom remission rates of treated and untreated patients were 81.1% (107/132) and 46.2% (6/13), respectively ( = 0.009). The cumulative 1-, 5-, 10-, 20-, and 30-year survival rates of the treated patients were 93.5%, 81.6%, 75.2%, 64.7%, and 58.2%, respectively; however, the 1-, 5-, 10-, 20-, and 30-year survival rates of the untreated patients were 70.8%, 70.8%, 53.1%, 0%, and unavailable, respectively ( = 0.007). Independent predictors of survival for treated patients were gastroesophageal variceal bleeding (HR = 3.043, 95%CI: 1.363-6.791, = 0.007) and restenosis (HR = 4.610, 95%CI: 1.916-11.091, = 0.001). The cumulative 1-, 5-, 10-, 20-, and 30-year mortality rates for hepatocellular carcinoma were 0%, 2.6%, 3.5%, 8%, and 17.4%, respectively.
CONCLUSION
Long-term survival is satisfactory for treated Chinese patients with BCS. Hepatocellular carcinoma is a chronic complication and should be monitored with long-term follow-up.
目的
研究中国一家三级医院 30 年布-加综合征（BCS）的治疗结果。
方法
对 1983 年 11 月至 2013 年 9 月期间在我院诊断为原发性 BCS 的 256 例患者进行随访和回顾性研究。通过 Kaplan-Meier 分析计算累积生存率和主要死因的累积死亡率，并采用 Cox 回归模型确定生存的独立预测因子。
结果
34 例患者未接受治疗；然而，222 例患者接受了药物、手术或介入放射学治疗。44 例患者失访；然而，有 212 例患者接受了随访，其中 67 例死亡。治疗组和未治疗组的症状缓解率分别为 81.1%（107/132）和 46.2%（6/13）（=0.009）。治疗组患者的 1 年、5 年、10 年、20 年和 30 年累积生存率分别为 93.5%、81.6%、75.2%、64.7%和 58.2%；然而，未治疗组患者的 1 年、5 年、10 年、20 年和 30 年累积生存率分别为 70.8%、70.8%、53.1%、0%和不可用（=0.007）。治疗组患者生存的独立预测因子是胃食管静脉曲张出血（HR=3.043，95%CI：1.363-6.791，=0.007）和再狭窄（HR=4.610，95%CI：1.916-11.091，=0.001）。肝细胞癌的累积 1 年、5 年、10 年、20 年和 30 年死亡率分别为 0%、2.6%、3.5%、8%和 17.4%。
结论
中国 BCS 患者经治疗后长期生存情况满意。肝细胞癌是一种慢性并发症，应通过长期随访进行监测。
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