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作 者:吴猛[1] 张庆桥[1] 祖茂衡[1] 徐浩[1] 李晶英[2]
机构地区:[1]徐州医学院附属医院介入放射科,江苏徐州221002 [2]徐州医学院附属医院放射科,江苏徐州221002
出 处:《中国介入影像与治疗学》2013年第2期89-93,共5页Chinese Journal of Interventional Imaging and Therapy
摘 要:目的观察Budd-Chiari综合征(BCS)介入术后复发患者的临床特点。方法回顾性分析49例复发BCS患者的临床资料及治疗预后情况。根据预后分为死亡组(n=11)和生存组(n=38),再将生存组分为再次复发组(n=14)与未再次复发组(n=24),分别计算各组病例Child-Pugh评分、Clichy指数、Rotterdam指数和New-Clichy指数,以ROC曲线衡量各指标预测患者预后的价值。结果根据ROC曲线,New-Clichy指数的截断点为4.37,New-Clichy指数>4.37者死亡率为62.50%(10/16),New-Clichy指数<4.37者死亡率为3.03%(1/33),死亡组New-Clichy指数显著高于生存组(P=0.038)。再次复发组平均年龄(P=0.016)、胆红素水平(P=0.014)、Clichy指数(P=0.042)明显低于未再次复发组。结论对于多数BCS介入术后复发患者,介入治疗仍属安全、有效、可行。New-Clichy指数对预测复发BCS介入术后死亡事件有较高价值。Objective To observe the clinical characteristics of patients with recurrence of Budd-Chiari syndrome(BCS) after interventional therapy.Methods The clinical data and follow-up results of 49 recurrent BCS patients after interventional treatment were retrospectively analyzed.The patients were divided into death group(n=11) and survival group(n=38),and then according to second interventional treatment,patients in survival group were divided into twice recurrent group(n=14) and non-twice recurrent group(n=24).Child-Pugh scoring,Clichy index,Rotterdam index and New-Clichy index of all groups were calculated for evaluating the correlation between prognosis and the above indexes by ROC cure.Results The inflection point of New-Clichy was 4.37 according to ROC cure.The mortality of patients with New-Clichy index &gt;4.37 was 62.50%(10/16),of patients with New-Clichy index &lt;4.37 was 3.03%(1/33),while New-Clichy index of death group was significantly higher than that of survival group(P=0.038).The mean age(P=0.016),bilirubin level(P=0.014) and the Clichy-PI(P=0.042) were all significantly lower in twice recurrent group than those in non-twice recurrent group.Conclusion Interventional treatment is still safe and effective for patients with recurrent BCS.New-Clichy index has better predictive value for death and survival for patients with recurrent BCS.
关 键 词:BUDD-CHIARI综合征 复发 New-Clichy指数 Clichy指数
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