布加综合征患者侧支循环类型与肝功能Child分级的相关性研究  

The correlation between collateral pathway development and Child- Pugh scores in Budd-Chiarisyndrome

作　　者：吴磊[1] 姚群立[1] 祖茂衡 徐浩 

机构地区：[1]江苏省张家港市中医医院南京中医药大学附属张家港医院介入放射科,215600 [2]徐州医科大学附属医院介入放射科

出　　处：《中华普通外科杂志》2018年第2期118-121,共4页Chinese Journal of General Surgery

摘　　要：目的利用磁共振肝脏加速容积采集技术（1iveraccelerationvolumeacquisition，LAVA）研究布加综合征（Budd—Chiarisyndrome，BCS）患者肝内外侧支循环与肝功能Child分级的相关性。方法回顾性分析146例患者行LAVA增强MRI和数字减影血管造影（digitalsubtractionangiography，DSA）检查的BCS患者的临床资料。用Child—Pugh改良分级法对患者肝功能进行分级。利用磁共振LAVA技术统计肝内外侧支循环的种类及数量，用Kappa一致性检验评价肝内外侧支循环的一致性。采用，检验判断侧支循环类型与肝功能Child分级的相关性。选用Cramer修正列联系数描述其相关程度。结果146例BCS患者中，肝功能A级患者50例，肝功能B级患者79例，肝功能c级患者17例。MRI显示肝内外开放的侧支循环中仅副肝静脉和腹壁浅静脉侧支建立与BCS患者肝功能分级具有相关性（x2=0．324，P〈0．05.X2=11．855，P〈0．05），其与肝功能分级的相关程度分别为0．373、0．285。其中，副肝静脉扩张与肝功能A级、c级有关联性（x2=7．159，P〈0．05x2=17．662，P〈0．05）。腹壁浅静脉侧支建立与肝功能A级、B级有关联性（x2=7．244，P〈0．05、x2=11．855，P〈0．05）。结论副肝静脉和腹壁浅静脉侧支建立与BCS患者肝功能分级相关。Objective To study the intra- and extra-hepatic collateral pathways in various Child- Pugh scores by using liver acceleration volume acquisition （LAVA） enhanced magnetic resonance imaging （MRI）. Methods The clinical data and imaging findings of 146 patients with Budd-Chiari syndrome （BCS） were collected and analyzed. Intra- and extra-hepatic collateral pathways were evaluated by LAVA enhanced MRI. Intra- and extra-hepatic collateral pathways was analyzed using the Kappa identity test. Correlations of the intra-/extra-hepatic collateral pathways with Child-Pugh scores were analyzed using the Chi-square test. Correlation was calculated by the Cramer correction coefficient of contingency. Results Among 146 BCS patients there were 50 grade A patients, 79 grade B patients and 17 grade C patients. Among MRI demonstrated 6 types dilated collateral shunts, only accessory hepatic veins （ AHVs ） and superficial epigastric veins （SEVs） as collateral pathways were associated with the Child- Pugh scores （X2 = 20. 324, P 〈 0. 05, X2 = 11. 855, P 〈 0. 05, respectively） . AHVs as collateral pathways were associated with score A and score C （X2 =7. 159,P 〈0. 05, X2 = 17. 662,P 〈0. 05, respectively）, while SEVswere with score A and score B （X2 =7.244,P〈0.05,X2 = 11.855, P〈0.05, respectively）. Conclusion AHVs and SEVs as collateral pathways were associated with Child-Pugh scores in cases of Budd-Chiari syndrome.

关 键 词：布加综合征 侧支循环 磁共振成像 肝功能CHILD分级 

分 类 号：R575[医药卫生—消化系统]