| 血清 AST/ALT比值与布加综合征预后的关系 |
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| 引用本文： | 张言巧子,于娜娜,徐凯. 血清 AST/ALT比值与布加综合征预后的关系[J]. 天津医药, 2019, 47(4): 421-424. DOI: 10.11958/20181958 |
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| 作者姓名： | 张言巧子 于娜娜 徐凯 |
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| 作者单位： | 徐州医科大学附属医院影像科（邮编 221000） |
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| 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-rank χ2=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。
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| 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 |
| 收稿时间： | 2018-12-07 |
| 修稿时间： | 2019-03-23 |
Relationship between serum AST/ALT ratio and prognosis of Budd-Chiari syndrome |
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| ZHANG Yan-qiao-zi,YU Na-na,XU Kai. Relationship between serum AST/ALT ratio and prognosis of Budd-Chiari syndrome[J]. Tianjin Medical Journal, 2019, 47(4): 421-424. DOI: 10.11958/20181958 |
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| Authors: | ZHANG Yan-qiao-zi YU Na-na XU Kai |
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| Affiliation: | Department of Radiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, China |
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| Abstract: | 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 280patients with BCS admitted to the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. Themedian value of AST/ALT ratio (0.75) was used for grouping. There were 142 cases in group AST/ALT ratio ≤ 0.75 and 138cases 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 andrecurrence was analyzed retrospectively. Results There were significant differences in gender, Child-Pugh grade of liverfunction 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 significantlyshorter in AST/ALT ratio > 0.75 group than that of AST/ALT ratio ≤ 0.75 group (Z=2.159，P＜0.05). The cumulative patencyrates were 94.4%, 76.8% and 64.1%, respectively in AST / ALT ratio ≤0.75 group for 1, 3 and 5 years. The cumulativepatency 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-yearcumulative patency rate was significantly lower in patients with AST/ALT>0.75 group than that of patients with AST/ALT≤0.75 group (Log-rank χ2=4.372，P＜0.05). Multivariate Cox regression analysis showed that the liver function of Child-Pughclassification (C) patients were easy to relapse BCS. Conclusion AST/ALT ratio is associated with recurrence of BCS afterinterventional therapy. Child-Pugh classification of liver function is an independent risk factor for the prognosis of BCS. |
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| Keywords: | Budd-Chiari syndrome alanine transaminase aspartate aminotransferases recurrence risk factors AST/ALT ratio |
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