Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University, Japan.
Department of Hepatology, Graduate School of Medicine, Osaka City University, Japan.
Intern Med. 2022 Apr 1;61(7):959-967. doi: 10.2169/internalmedicine.8020-21. Epub 2021 Sep 18.
Objective Mapping the long-term prognosis of Budd-Chiari syndrome (BCS) is difficult, as the prognosis is associated with changes in the liver function. The present study evaluated the time course changes in the liver function in a treatment group with percutaneous old balloon angioplasty (POBA) and a non-treatment group using the albumin-bilirubin score (ALBI) and Child-Pugh score during long-term follow-up. Methods In this retrospective study, 13 consecutive patients diagnosed with BCS at our hospital between 2007 and 2020 were categorized into a treatment group (n=8), which received POBA, and a non-treatment group (n=5). Differences in the liver function in the ALBI and Child-Pugh scores between the initial visit and one- and three-year follow-up were calculated and statistically evaluated. We investigated the changes in the liver function during the long-term follow-up, including events such as re-stenosis and re-treatment. Results While the Child-Pugh scores in the treatment group did not differ significantly between the initial visit and 1- or 3-year follow-up, the ALBI scores in this group improved significantly between the initial visit and the 1- or 3-year follow-up visit (p=0.0078 and 0.0156, respectively). The liver function according to the ALBI score in the treatment group showed gradual improvement from the initial value but gradual worsening in the non-treatment group. The ALBI scores also revealed that the liver function varies according to re-stenosis and re-POBA in BCS patients. Conclusion Unlike the Child-Pugh score, the ALBI score was able to capture changes in the liver function of BCS patients during the long-term course of BCS.
布加综合征(BCS)的长期预后难以预测,因为其预后与肝功能变化相关。本研究通过白蛋白-胆红素评分(ALBI)和Child-Pugh 评分评估经皮陈旧球囊血管成形术(POBA)治疗组和未治疗组在长期随访过程中肝功能的时间变化过程。
本回顾性研究纳入了 2007 年至 2020 年期间在我院诊断为 BCS 的 13 例连续患者,分为治疗组(n=8)和未治疗组(n=5)。分别计算初始就诊时和 1 年及 3 年随访时 ALBI 和 Child-Pugh 评分的肝功能差异,并进行统计学评估。我们调查了长期随访期间肝功能的变化,包括再狭窄和再治疗等事件。
治疗组的 Child-Pugh 评分在初始就诊时和 1 年或 3 年随访时无显著差异,但 ALBI 评分在这两个时间点均显著改善(p=0.0078 和 0.0156)。治疗组的肝功能根据 ALBI 评分逐渐改善,但未治疗组的肝功能逐渐恶化。ALBI 评分还表明,BCS 患者的肝功能根据再狭窄和再行 POBA 而变化。
与 Child-Pugh 评分不同,ALBI 评分能够在 BCS 的长期病程中捕捉到 BCS 患者的肝功能变化。