汉族人群布加综合征患者膜性阻塞病因探讨  

Mechanism of membranous obstruction in Chinese Han Budd-Chiari syndrome patients

作　　者：王进广[1] 乔晓春[2] 祁冬[2] 王利明[1] 

机构地区：[1]蚌埠市第一人民医院消化内科,安徽蚌埠233000 [2]蚌埠市第一人民医院医学影像科,安徽蚌埠233000

出　　处：《胃肠病学和肝病学杂志》2016年第1期90-93,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨汉族人群布加综合征患者膜性阻塞形成原因。方法选取2012年4月-2013年12月在蚌埠市第一人民医院接受诊疗的布加综合征患者93例作为研究对象,所有患者均接受下腔静脉（inferior vena cava,IVC）、肝静脉（hepatic veins,HVs）计算机断层扫描造影（computerized tomographly angiography,CTA）检查,评估血管病变情况。结果 IVC病变者39例（41.94%）,HVs病变者23例（24.73%）,同时受累者31例（33.33%）。IVC病变最常见的类型为膜性阻塞（43.59%）,HVs病变最常见的类型为非膜性阻塞（47.83%）,HVs非膜性阻塞伴IVC膜性或非膜性阻塞也是较常见类型（分别为38.71%和41.94%）。单纯IVC病变和单纯HVs病变患者中各自相应类型之间首次发病时的年龄分布未见明显差异（P〉0.05）。与非膜性阻塞相比,在IVC受累（Ⅰ型和Ⅲ型）和HVs受累（Ⅱ型和Ⅲ型）患者中,膜性阻塞患者的首次发病年龄较小,但差异无统计学意义（P〉0.05）。通过年龄-类型分布图发现,多数患者首次发病年龄为30~50岁,且主要的类型为HVs或IVC膜性阻塞。随着年龄的增长（50~70岁）,膜性阻塞发生率迅速下降。结论汉族人群布加综合征患者以IVC膜性阻塞多见,膜性阻塞与非膜性阻塞患者发病年龄之间差异无统计学意义。Objective To investigate the underlying mechanisms of the formation of membranous obstruction in Chi- nese Han Budd-Chiari syndrome patients. Methods A total of 93 patients with Budd-Chiari syndrome from Apr. 2012 to Dec. 2013 were enrolled as the subjects. Each patient accepted an examination of computerized tomography angiogra- phy （CTA） to evaluate the impairments in hepatic veins （HVs） and inferior vena cava （IVC）. Results Thirty-nine eases （41.94%） had obstructions in IVC, 23 eases （24.73%） in HVs and 31 eases （33.33%） in both. The most common type of obstruction in IVC was membranous （43.59%） , and which in HVs was non-membranous （47.83%）. It was also a common type that patients with the presence of non-membranous obstructions in HVs accompanying mem- branous or non-membranous obstructions in IVC （38.71% , 41.94% ）. There was no significant difference as to the age for the first time to identify Budd-Chiari syndrome in patients IVC-involved or HVs-involved singly （P 〉 0.05）. In pa- tients IVC-involved （type Ⅰ and type Ⅲ ） and HVs-involved （ type Ⅱ and type Ⅲ ） , compared with non-membranous ob- structions, patients with membranous obstructions seemed to be slightly younger, however, there was no significant difference （P 〉 0.05）. Most subjects were from 30 to 50 years old, with the most common type of membranous obstruc- tions in HVs or IVC. With the increase of age （from 50 to 70 years old） , the occurrence of membranous obstructions in HVs or IVC decreased sharply. Conclusion In Chinese Han cohort, membranous obstruction is the most common injury in Budd-Cbiari syndrome patients. We failed to find a remarkable difference as to the age to identify Budd-Chiari syn- drome between the type of membranous and non-membranous obstruction.

关 键 词：布加综合征 膜性阻塞 非膜性阻塞 肝静脉 下腔静脉 

分 类 号：R575[医药卫生—消化系统]