布-加综合征血管开通术后合并肝细胞癌的危险因素分析  

Analysis of risk factors of Budd-Chiari syndrome associated with hepatocellular carcinoma in patients who underwent endovascular recanalization

作　　者：康伟 张庆桥 肖晋昌 黄乾鑫 杨晶 魏宁 崔艳峰 刘洪涛 徐浩 祖茂衡 Kang Wei;Zhang Qingqiao;Xiao Jinchang;Huang Qianxin;Yang Jing;Wei Ning;Cui Yanfeng;Liu Hongtao;Xu Hao;Zu Maoheng(Department of Interventional Radiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学附属医院介入放射科,徐州221006

出　　处：《中华肝胆外科杂志》2022年第11期822-826,共5页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的:探讨布-加综合征(BCS)血管开通术后合并肝细胞癌的危险因素。方法:回顾性分析2015年1月至2021年6月徐州医科大学附属医院行血管开通术的340例BCS患者临床资料。经倾向性评分匹配后共入组57例患者,其中男性40例,女性17例,年龄(50.4±8.7)岁。按照BCS血管开通术后是否合并肝细胞癌分为肝细胞癌组(n=19)和对照组(n=38)。比较匹配后两组男性比例、年龄、BCS类型、终末期肝病模型(MELD)评分等术前指标,以及甲胎蛋白、肝内结节形成、血管再狭窄、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)等术后指标。进一步采用多因素logistic回归分析BCS患者血管开通术后合并肝细胞癌的危险因素。结果:两组男性比例、年龄、BCS类型、MELD评分等术前资料比较,差异均无统计学意义(均P>0.05)。肝细胞癌组术后甲胎蛋白>9.0μg/L、AST>40 U/L、ALT>50 U/L、肝内结节形成以及血管再狭窄比例高于对照组,差异有统计学意义(均P<0.05)。多因素分析表明,术后甲胎蛋白>9.0μg/L(OR=46.778,95%CI:3.310~661.140)、AST>40 U/L(OR=36.307,95%CI:1.317~1001.009)、肝内结节形成(OR=66.254,95%CI:4.225~1038.974)、血管再狭窄(OR=16.276,95%CI:1.712~154.773)的BCS血管开通术后合并肝细胞癌的风险增加(均P<0.05)。结论:术后甲胎蛋白>9.0μg/L、AST>40 U/L、肝内结节形成以及血管再狭窄是BCS血管开通术后合并肝细胞癌的独立危险因素。Objective To study the risk factors of Budd-Chiari syndrome(BCS)associated with hepatocellular carcinoma in patients who underwent endovascular recanalization.Methods The data of 340 patients with BCS who underwent endovascular recanalization at the Affiliated Hospital of Xuzhou Medical University between January 2015 and June 2021 were retrospectively collected.Using propensity score matching,a total of 57 patients(40 males and 17 females)were enrolled into this study,with the age of(50.4±8.7)years.Patients were divided into the hepatocellular carcinoma group(n=19)and the control group(n=38)according to whether occurrence of hepatocellular carcinoma after cardovascular recanalization.Preoperative indicators including gender,age,BCS type,and model for end-stage liver disease(MELD)score,and postoperative indicators including alpha fetoprotein,intrahepatic nodule formation,vascular restenosis,aspartate aminotransferase(AST)and alanine aminotransferase(ALT)were compared between the two groups after propensity score matching.Multivariate logistic regression analysis was used to analyze the risk factors of BCS associated with after endovascular recanalization in these patients.Results There were no significant differences in gender,age,BCS type,MELD score and other preoperative data between the two groups(all P>0.05).The proportions of patients with postoperative alpha fetoprotein>9.0μg/L,AST>40 U/L,ALT>50 U/L,intrahepatic nodules and vascular restenosis after endovascular treatment in the hepatocellular carcinoma group were significantly higher than those in the control group(all P<0.05).Multivariate analysis showed postoperative alpha fetoprotein>9.0μg/L(OR=46.778,95%CI:3.310-661.140),AST>40 U/L(OR=36.307,95%CI:1.317-1001.009),intrahepatic nodule formation(OR=66.254,95%CI:4.225-1038.974)and vascular restenosis(OR=16.276,95%CI:1.712-154.773)to have an increased risk of being associated with hepatocellular carcinoma in these BCS patients(all P<0.05).Conclusion Postoperative alpha fetoprotein>9.0μg/L,AST>40 U/L,int

关 键 词：BUDD-CHIARI综合征 癌 肝细胞 危险因素 血管开通术 

分 类 号：R735.7[医药卫生—肿瘤]