血清AST/ALT比值与布加综合征预后的关系  

Relationship between serum AST/ALT ratio and prognosis of Budd-Chiari syndrome

作　　者：张言巧子 于娜娜 徐凯 ZHANG Yan-qiao-zi;YU Na-na;XU Kai(Department of Radiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院影像科,221000

出　　处：《天津医药》2019年第4期421-424,共4页Tianjin Medical Journal

摘　　要：目的分析术前血清天冬氨酸转氨酶(AST)/丙氨酸转氨酶(ALT)比值(AST/ALT)与布加综合征(BCS)患者预后的关系。方法回顾性分析徐州医科大学附属医院收治的280例BCS患者的临床资料,以AST/ALT比值的中位数(0.75)进行分组,AST/ALT比值≤0.75组142例,AST/ALT比值>0.75组138例。所有患者均接受介入手术治疗,术后进行随访,随访至复发或至2018年11月,比较不同AST/ALT比值水平术后通畅时间、累积通畅率差异,并采用Cox回归分析BCS患者复发的影响因素。结果 2组不同性别、肝功能Child-Pugh分级和复发比例差异均有统计学意义。AST/ALT比值≤0.75组和AST/ALT比值>0.75组血管平均通畅时间分别为45(37,52)、40(21,49)个月,AST/ALT比值>0.75组血管通畅时间短于AST/ALT比值≤0.75组(Z=2.159,P<0.05)。AST/ALT比值≤0.75组1、3、5年累积通畅率分别为94.4%、76.8%、64.1%,AST/ALT比值>0.75组1、3、5年累积通畅率分别为90.6%、68.1%、58.7%,AST/ALT比值>0.75组5年累积通畅率低于AST/ALT比值≤0.75组(Log-rankχ2=4.372,P<0.05)。多因素Cox回归分析结果显示,肝功能Child-Pugh分级(C级)患者容易复发BCS。结论 AST/ALT比值与BCS介入术后复发相关,肝功能ChildPugh分级(C级)是影响BCS预后的独立危险因素。Objective To analyze the relationship between preoperative serum alanine aspartate aminotransferase/aminotransferase(AST/ALT)ratio and prognosis of patients with Budd-Chiari syndrome(BCS).Methods Data of 280 patients with BCS admitted to the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed.The median value of AST/ALT ratio(0.75)was used for grouping.There were 142 cases in group AST/ALT ratio≤0.75 and 138 cases in group AST/ALT ratio>0.75.All patients underwent interventional surgery and followed up for at least 5 years.According to the recurrence of follow-up results,the relationship between preoperative serum AST/ALT levels and recurrence was analyzed retrospectively.Results There were significant differences in gender,Child-Pugh grade of liver function and recurrence rate between the two groups.The mean vascular patency time were 45(37,52)and 40(21,49)months for AST/ALT ratio≤0.75 group and AST/ALT ratio>0.75 group.The mean vascular patency time was significantly shorter in AST/ALT ratio>0.75 group than that of AST/ALT ratio≤0.75 group(Z=2.159,P<0.05).The cumulative patency rates were 94.4%,76.8%and 64.1%,respectively in AST/ALT ratio≤0.75 group for 1,3 and 5 years.The cumulative patency rates were 90.6%,68.1%and 58.7%in AST/ALT ratio>0.75 group for 1,3 and 5 years,respectively.The 5-year cumulative patency rate was significantly lower in patients with AST/ALT>0.75 group than that of patients with AST/ALT≤0.75 group(Log-rankχ^2=4.372,P<0.05).Multivariate Cox regression analysis showed that the liver function of Child-Pugh classification(C)patients were easy to relapse BCS.Conclusion AST/ALT ratio is associated with recurrence of BCS after interventionaltherapy.Child-PughclassificationofliverfunctionisanindependentriskfactorfortheprognosisofBCS.

关 键 词：布加综合征 丙氨酸转氨酶 天冬氨酸氨基转移酶类 复发 危险因素 AST/ALT比值 

分 类 号：R575[医药卫生—消化系统]