菊叶三七致肝小静脉闭塞病35例临床分析  

An analysis of 35 cases with gynura segetum-induced hepatic veno-occlusive disease

作　　者：赵利珍 卞京京 李燕敏 陆召军 高修银 ZHAO Lizhen;BIAN Jingjing;LI Yanmin;LU Zhaojun;GAO Xiuyin(College of Graduate,Xuzhou Medical University,Xuzhou,Jiangsu 221002,China;Shool ofPublic Health,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Section ofGeneral Medicine,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China)

机构地区：[1]徐州医科大学研究生学院,江苏徐州221002 [2]徐州医科大学公共卫生学院,江苏徐州221004 [3]徐州医科大学全科医学教研室,江苏徐州221004

出　　处：《安徽医药》2019年第5期1057-1060,共4页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金资助项目(81172604/H2401)

摘　　要：目的分析菊叶三七(土三七)导致肝小静脉闭塞病(HVOD)的临床特点、诊治方法和预后。方法回顾性分析35例因服用土三七所致肝小静脉阻塞病的临床资料。结果 HVOD临床表现为腹水(91%)、腹胀(86%)、纳差(71%)、乏力(71%)、肝肿大(66%)等。彩超可见肝大、腹水、肝内"豹纹状"、"斑片状"低回声区等,增强CT可见特征性"地图状"不均匀强化影。出院后随访1周至3年,失访3例,死亡13例,治愈/好转19例;死亡组病人白细胞计数、凝血酶原时间、血肌酐、尿素氮水平较治愈/好转组病人相对较高(P<0.05)。结论 HVOD病程相对较短,诊治困难,预后较差。Objective To investigate the clinical characteristics,diagnosis,treatment and prognosis of hepatic veno-occlusive disease(HVOD)induced by gynura segetum.Methods A total of 35 HVOD patients induced by gynura segetum was retrospectively analyzed.Results The clinical symptoms of 35 HVOD patients included ascites(91%),abdominal dissension(86%),poor appetite(71%),feeble(71%),hepatom-egaly(66%).Image examination showed hepatomegaly,ascites and“leopard”or“patchy”low echo area in color doppler ultrasound,and characteristic“map”or“patchy”enhancement in enhanced computed tomography(CT).Followed up from one week to three years,3 cases were lost to follow-up,13 cases were died and 19 cases were cured or better.The prothrombin time(PT)was longer,and WBC,Scr and BUN were higher in dead patients than those in cured or better patients(P<0.05).Conclusion The HVOD has short course,difficult diagnosis,limited treatment and poor prognosis.

关 键 词：肝静脉闭塞性疾病 景天三七 腹水 肝肿大 生物碱类 

分 类 号：R575[医药卫生—消化系统]