目的:探讨布加综合征(BCS)患者腔内治疗后首次复发的独立危险因素。并建立预测目标患者复发的预测模型。
方法:对2010年1月至2015年12月在徐州医科大学附属医院行血管内治疗的BCS患者进行回顾性分析。他们的临床,实验室测试,和成像数据收集和分析。确定了复发的独立危险因素,建立并验证了预测模型。
结果:共有450名患者符合过滤标准,102在随访期间复发。中位随访时间为87个月,1至137个月不等。1-,3-,5年和10年累积复发率为9.11%(6.41-11.73%),17.35%(13.77-20.78%),20.10%(16.30-23.72%),和23.06%(18.86-27.04%),分别。肝硬化,腹水,血栓形成,所有肝内引流静脉阻塞(阻塞HV+AHV)是独立的危险因素,年龄是一个独立的保护因素。预测模型命名为MRBET。基于模型,每位患者的风险评分等于(-0.385981*年龄/10)+(0.0404184*PT)+(0.0943423*CRE/10)+(0.0157053*LDH/10)+(0.592179*LC)+(0.896034*腹水)+(0.691346*血栓形成)+(0.886741*阻塞性HV+AHV),高风险组(风险评分≥1.57)的患者复发的可能性高于低风险组(HR=6.911,p<0.001).MRBET模型也可以在https://mrbet上作为网络工具获得。shinyapps.io/dynnomapp.
结论:肝硬化,腹水,血栓形成,而梗阻性HV+AHV是首次复发的独立危险因素;年龄是独立的保护因素。该预测模型能有效、方便地预测复发风险,筛选出高复发风险患者。
OBJECTIVE: To investigate the independent risk factors for the first recurrence after endovascular management in patients with Budd-Chiari syndrome (BCS), and to establish a prediction model for predicting recurrence in target patients.
METHODS: BCS patients who underwent endovascular treatment in the Affiliated Hospital of Xuzhou Medical University from January 2010 to December 2015 were retrospectively examined, with their clinical, laboratory test, and imaging data collected and analyzed. Independent risk factors for recurrence were identified, and a prediction model was established and validated.
RESULTS: A total of 450 patients met the filtering criteria, and 102 recurred during the follow-up. The median follow-up time was 87 months, ranging from 1 to 137 months. The 1-, 3-, 5- and 10-year cumulative recurrence rate was 9.11% (6.41-11.73%), 17.35% (13.77-20.78%), 20.10% (16.30-23.72%), and 23.06% (18.86-27.04%), respectively. Liver cirrhosis, ascites, thrombosis, and all the main intrahepatic drainage veins obstructed (obstructed HV + AHV) are independent risk factors, while age is an independent protective factor. The prediction model was named MRBET. Based on the model, the risk score of each patient equals (-0.385981 * Age/10) + (0.0404184 * PT) + (0.0943423 * CRE/10) + (0.0157053 * LDH/10) + (0.592179 * LC) + (0.896034 * Ascites) + (0.691346 * Thrombosis) + (0.886741 * obstructed HV + AHV), and those in the high-risk group (risk score ≥ 1.57) were more likely to recur than those in the low-risk group (HR = 6.911, p < 0.001). The MRBET model is also available as a web tool at https://mrbet.shinyapps.io/dynnomapp .
CONCLUSIONS: Liver cirrhosis, ascites, thrombosis, and obstructed HV + AHV are independent risk factors for the first recurrence; age is an independent protective factor. The prediction model can effectively and conveniently predict the risk of recurrence and screen out patients at a high recurrence risk.