布-加综合征、肝血窦阻塞综合征与肝硬化的鉴别

彭涛; 张国艳; 刘玉兰

布-加综合征、肝血窦阻塞综合征与肝硬化的鉴别

北京大学人民医院消化科

详细信息

中图分类号: R575.2;R575
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出版历程
- 收稿日期: 2011-09-13
- 出版日期: 2011-10-20

Identification of Budd-Chiari syndrome, hepatic sinusoidal obstruction syndrome and hepatic cirrhosis

摘要

摘要: 布-加综合征是由肝静脉或其开口以上的下腔静脉阻塞性病变引起的以下腔静脉阻塞、门静脉高压为特点的综合征,诊断依靠影像学检查,治疗的关键是解除梗阻。肝血窦阻塞综合征是指肝窦内皮完整性破坏和肝窦内充血阻塞而产生的肝内窦后性门静脉高压症,临床表现类似布-加综合征,诊断依靠肝组织活检。这两种疾病的治疗和预后均与肝实质病变导致的肝硬化不同,所以临床上需要注意这三种疾病的鉴别。
- Budd-Chiari综合征 /
- 肝硬化 /
- 肝窦阻塞综合征
Abstract: The Budd-Chiari syndrome (BCS) is caused by obstruction of the hepatic venous or the inferior vena cava which results in hepatic sinusoidal pressure increased and portal hypertension.The diagnosis of BCS depends on imageology.The key point of the therapy is the relief of the obstruction.The pathomechanism of hepatic sinusoidal obstruction syndrome (SOS) is intrahepatic portal vein hypertension result from damaged of the integrity of sinusoidal endothelial, which causes sinusoidal congestion.Its clinical manifestation is similar to BCS.Its diagnosis depends on pathology.The therapy and prognosis of the two diseases is different from liver cirrhosis caused by the liver parenchyma disease, so it is important to distinguish the three diseases.
- Budd-Chiari syndrome /
- liver cirrhosis /
- hepatic sinusoidal obstruction syndrome

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参考文献(25)

[1]Valla D.Hepatic venous outflow tract obstruction etipatho-genesis:Asia versus the West[J].J Gastroenterol Hepatol, 2004, 19 (Suppl 7) :S204-S211.

[2]Denninger MH, Chait Y, Casadevall N, et al.Cause of portalor hepatic venous thrombosis in adults:the role of multipleconcurrent factors[J].Hepatology, 2000, 31 (3) :587-591.

[3] 李艳奎, 张小明, 沈晨阳, 等.膜性梗阻型布一加综合征隔膜和机化血栓组织中相关细胞因子表达的研究[J].中华普通外科杂志, 2008, 23 (8) :618-621.

[4]Noone TC, Semelka RC, Siegelman ES, et al.Budd-Chiarisyndrome:spectrum of appearances of acute, subacute, and chronic disease with magnetic resonance imaging[J].JMagn Reson Imaging, 2000, 11 (1) :44-50.

[5]Laurie D.DeLeve, Dominique-Charles Valla, Guadalupe Garcia-Tsao.Vascular Disorders of the Liver[J].Hepatology, 2009, 49:1729-1764.

[6]Giuseppe B, Valérie V, Michael PF, et al.Budd-Chiari Syn-drome:Spectrum of Imaging Findings[J].American Roent-gen Ray Society, 2007, 188 (2) :W168-W176.

[7]Sharma S, Texeira A, Texeira P, et al.Pharmacological throm-bolysis in Budd Chiari syndrome:A single centre experience andreview of the literature[J].J Hepatol, 2004, 40 (1) :172-180.

[8]Mancuso A, Fung K, Mela M, et al.TIPS for acute andchronic Budd-Chiari syndrome:A single-centre experi-ence[J].J Hepatol, 2003, 38 (6) :751-754.

[9]DeLeve LD, Shulman HM, McDonald GB.Toxic injury to he-patic sinusoids:sinusoidal obstruction syndrome (veno-oc-clusive disease) [J].Semin Liver Dis, 2002, 22 (1) :27-42.

[10]Lee JL, Gooley T, Bensinger W, et al.Venocclusive diseaseof the liver after high-dose chemotherapy with alkylating a-gents:incidence, outcome and risk fac-tors[J].Hepatolo-gy, 1997, 26:149A.

[11]Laura Rubbia-Brandt.Sinusoidal Obstruction Syndrome[J].Clin Liver Dis, 2010, 14 (4) :651-668.

[12]Dickinson AM, Holler E.Polymorphisms of cytokine and in-nate immunity genes and GVHD[J].Best Pract Res ClinHaematol, 2008, 21 (2) :149-164.

[13]Schots R, Kaufman L, Van Riet I, et al.Proinflammatory cy-tokines and their role in the development of major transplant-related complications in the early phase after allogeneicbone marrow transplantation[J].Leukemia, 2003, 17 (6) :1150-1156.

[14]Rubbia-Brandt L, Lauwers GY, Wuang H, et al.Sinusoidalobstruction syndrome and nodular regenerative hyperplasiaare frequent oxaliplatin associated liver lesions and partiallyprevented by bevacizumab in patients with hepatic colorectalmetastasis[J].Histopathology, 2010, 56 (4) :430-439.

[15]Jevtic D, Vujic D, Zecevic Z, et al.Coagulation disturbancesin paediatric patients with hepatic veno-occlusive diseaseafter stem cells transplantation[J].Srp Arh Celok Uk, 2010, 138 (Suppl 1) :33-38.

[16]梁扩寰.肝脏病学[M].北京:人民卫生出版社, 2003:1111-1115.

[17]McCarville MB, Hoffer FA, Howard SC, et al.Hepatic veno-occlusive disease in children undergoing bone-marrowtransplantation:usefulness of sonographic findings[J].Ped-iatr Radiol, 2001, 31 (2) :102-105.

[18]Shulman HM, Gooley T, Dudley MD, et al.Utility of trans-venous liver biopsies and wedged hepatic venous pressuremeasurements in sixty marrow transplant recipients[J].Transplantation, 1995, 59 (7) :1015-1122.

[19]Carreras E, Granena A, Navasa M, et al.On the reliability ofclinical criteria for the diagnosis of hepatic veno-occlusivedisease[J].Ann Hematol, 1993, 66 (2) :77-80.

[20]Bearman SI.The syndrome of hepatic veno-occlusive dis-ease after marrow transplantation[J].Blood, 1995 (11) , 85:3005-3020.

[21]Bearman SI, Lee JL, Baron AE, et al.Treatment of hepaticvenocclusive disease with recombinant human tissue plas-minogen activator and heparin in 42 marrow transplant pa-tients[J].Blood, 1997, 89 (5) :1501-1506.

[22]Chen IL, Yang SN, Hsiao CC, et al.Treatment with high-dose methylprednisolone for hepatic veno-occlusive diseasein a child with rhabdomyosarcoma[J].Pediatr Neonatol, 2008, 49 (4) :141-144.

[23]Akyüz C, CaClar K, Emir S, et al.High-dose methylpred-nisolone treatment of hepatic veno-occlusive disease in achild with Wilms tumor[J].Pediatr Hematol Oncol, 2003, 20 (4) :345-349.

[24]Chanlandon Y, Roosnek E, Helg C, et al.Efficient prophy-laxis with defibrotide for hepatic veno-occlusive disease af-ter allogeneic stem cell transplantation (SCT) [J].Blood, 2002, 100:111a.

[25]Helmy A.updates in the pathogenesis and therapy of hepaticsinusoidal obstruction syndrome[J].Aliment Pharmacol T-her, 2006, 23 (1) :11-25.

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