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目的探讨国人Budd-Chiari综合征(BCS)发生肝静脉(HV)阻塞的类型与范围。资料与方法前瞻性研究231例BCS患者的彩色多普勒超声(US)、多层螺旋CT血管成像(MSCTA)、磁共振血管成像(MRA)和数字减影血管造影(DSA)等多种血管成像技术联合诊断的资料,其中男142例、女89例,年龄12～72岁、平均(41.45±10.33)岁。结果231例BCS共有HV受累226例(占97.84%),其中HV与下腔静脉同时受累193例(占83.55%),单纯HV阻塞型33例(占14.29%)。下腔静脉与HV复合阻塞193例中,左、中、右三支HV均阻塞者130例(占67.35%);左和中两支HV阻塞者51例(26.42%)。单纯性HV阻塞33例中,左、中、右三支主HV全部受累达32例(占96.97%)。结论国人BCS的HV阻塞率高达97.84%,病变分型中,以HV和下腔静脉的混合型阻塞最多见(83.55%)。
Objective To investigate the type and extent of occlusion of hepatic veins (HV) in Chinese Budd-Chiari syndrome (BCS). Materials and Methods A prospective study of 231 blood vessels in a variety of BCS patients such as color Doppler ultrasound, multi-slice spiral CT angiography (MSCTA), magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) There were 142 males and 89 females with an average age of (41.45 ± 10.33) years old, ranging in age from 12 to 72 years. Results A total of 226 BC patients (97.84%) were involved in 231 cases of BCS. There were 193 cases (83.55%) with HV and IVC simultaneously, and 33 cases (14.29%) with HV alone. Of the 193 cases with HV and IVC occlusion, there were 130 cases (67.35%) of HV occlusion in the left, middle and right HVs, and 51 cases (26.42%) in the left and middle HV occlusion cases. Of the 33 patients with simple HV obstruction, all of the three main HVs in the left, middle and right groups were involved in 32 cases (96.97%). Conclusion HV congestion rate of BCS is as high as 97.84% in China, and the mixed type of HV and IVC is the most common (83.55%) in the lesion classification.