Epidemiology of Budd-Chiari syndrome and its treatment by IVR

布加综合征的流行病学及IVR治疗

• 批准号: 03045025
• 负责人: KANEKO Masao
• 金额: $ 3.58万
• 依托单位: Hamamatsu University School of Medicine
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for international Scientific Research
• 财政年份: 1991
• 资助国家: 日本
• 起止时间: 1991 至 1993
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-03045025/
• 关键词: Budd-Chiari syndrome (BCS); Epidemiology; Dietary habit; BCS animal model; Laminaria constrictor; Interventional Radiology (IVR); Percutaneous transluminal angioplasty (PTA); Expandable metallic stent (EMS); Budd-Chiari症候群; Balloon angioplasty

Imaging diagnosis of Budd-Chiari Syndrome (BCS) being easier and more accurate by the definite criteria of the disease, however, BCS is rather rare in Japan statistically. In this study epidemiological investigation was performed by the co-operation of Chinese hospitals, where more BCS patients were available. Fifty-four patients (33 males, 21 females) of BCS over 15 years of age were subjected to study for the symptoms and laboratory findings as well as the recent dietary habit of the BCS patients, compared with the 14 control patients of each circulatory and digestive disease in accordance with the age and sex.The average onset ages were 30.3 years for males and 18.7 for females. Sex ratio was 1.57 ; more male than female. There was no characteristic family history nor past history. Abdominal distension and edema in the lower extremities were found in more than 75% of male and female patients. In males, melena, hematemesis and abdominal pain were frequently observed and abdominal pain and anorexia in females. It was noted that serum albumin was low and many patients had anemia and low platelet counts. More than 50% of the patients had enlarged liver, splenomegaly, esophageal varicies and dilated tortuous veins on the skin of abdominal and/or chest region. Smoking was not related to the disease. As for diet, BCS patients had more frequently potatoes and less frequently dried bean paste, rice in the morning, pork, vegetables and pear than 2 control groups. For fundamental study, experimental rat BCS model was developed by the use of laminaria constrictor.Thirty-two patients of BCS were treated by interventional radiology (IVR). The initial treatment of 21 cases was percutaneous transluminal angioplasty (PTA)) only and later 11 cases were treated by expandable metallic stent (EMS) from the beginning. Re-stenosis was treated by PTA and/or EMS. The long term follow-up encourages the good outcome of IVR on BCS.

Budd-Chiari综合征（BCS）的影像学诊断比较容易，而且根据疾病的明确标准，BCS的诊断也比较准确，但据统计，BCS在日本相当罕见。在这项研究中，流行病学调查是由中国医院合作进行的，那里有更多的BCS患者。本文对15岁以上BCS患者54例（男33例，女21例）的症状、实验室检查及近期饮食习惯进行了研究，并按年龄、性别分别与循环系统和消化系统疾病各14例对照，平均发病年龄男30.3岁，女18.7岁。性别比为1.57，男性多于女性。无典型家族史和既往史。男性和女性患者的腹胀和下肢水肿均超过75%。在雄性动物中，经常观察到黑便、呕血和腹痛，在雌性动物中经常观察到腹痛和厌食。观察到血清白蛋白低，许多患者贫血和血小板计数低。50%以上的患者有肝、脾肿大、食管静脉曲张及腹、胸部皮肤静脉迂曲扩张。吸烟与疾病无关。在饮食方面，BCS患者早晨吃土豆的频率高于2个对照组，而吃豆沙、米饭、猪肉、蔬菜和梨的频率低于2个对照组。在基础研究方面，采用海带缩窄法建立大鼠BCS模型，对32例BCS患者进行了介入治疗。21例患者仅行经皮腔内血管成形术（PTA），11例患者行金属内支架（EMS）治疗。再狭窄通过PTA和/或EMS治疗。长期随访表明IVR治疗BCS效果良好。

项目成果

岡和田 健敏,高橋 元一郎,宮崎 洋二郎,加藤 良一,加藤 俊彦,金子 昌生: "門脈内腫瘍塞栓に対するGianturco型expandable metallic stentの留置 -初期臨床経験-" 日本医学放射線学会雑誌. 52. 1599-1601 (1992)

Taketoshi Okawada、Motoichiro Takahashi、Yojiro Miyazaki、Ryoichi Kato、Toshihiko Kato、Masao Kaneko：“插入 Gianturco 型可扩张金属支架用于门静脉内肿瘤栓塞 - 初步临床经验 -” 日本医学放射学会杂志 52。 1599-1601。 (1992)

Ke Xu,Ming-Jun Han,Han-gue Zhang,Fang-xian He,Jing-rung Chang,Chang-lung Wang,Masao Kaneko,Motoichiro Takahashi,Taketoshi Okawada: "Clinical observation of Budd-Chiari syndrome treated by balloon angio-plasty(Report of 24 cases)(in Chinese)" Chinese Journ

徐科、韩明君、张汉歌、何芳贤、张景荣、王长龙、金子正夫、高桥本一郎、大川田刚俊：“球囊血管扩张术治疗布加综合征的临床观察”

高橋 元一郎,岡和田 健敏,加藤 良一,望月 隆男,大川 賀久,金子 昌生,徐 克,張 漢国,何 芳顕: "Rosch-Uchida Liver Access Setを用いたTIPSS(Transjugular Intrahepetic portosystemic Stent Shunt) -その妥当性に関するCTによる分析と臨床応用-" 日本医学放射線学会雑誌. 52. 1692-1694 (1992)

Genichiro Takahashi、Taketoshi Okawada、Ryoichi Kato、Takao Mochizuki、Kahisa Okawa、Masao Kaneko、Ke Xu、Hanguo Zhu、Fangxian He：“使用 Rosch-Uchida 肝脏通路套件的 TIPSS（经颈静脉肝内门体分流术） - 使用 CT 和 CT 进行有效性分析临床应用-》日本医学放射学会杂志. 52. 1692-1694 (1992)