血清 AST/ALT比值与布加综合征预后的关系

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。

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

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-rank χ2=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 interventional therapy. Child-Pugh classification of liver function is an independent risk factor for the prognosis of BCS.