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我国吡咯烷生物碱致肝窦阻塞综合征的临床特征分析

郭严 张世荣 文良志 刘凯军 胡辂 孙文静 王斌 魏艳玲 陈东风

引用本文:
Citation:

我国吡咯烷生物碱致肝窦阻塞综合征的临床特征分析

DOI: 10.3969/j.issn.1001-5256.2018.06.029
详细信息
  • 中图分类号: R575

Clinical features of sinusoidal obstruction syndrome induced by pyrrolidine alkaloids in China

  • 摘要:

    目的探讨我国吡咯烷生物碱致肝窦阻塞综合征的临床表现、治疗方法及预后。方法检索1980年1月-2017年4月我国107篇肝窦阻塞综合征临床报道文献,共计407例患者,总结该病的性别、年龄及分布地区,该病的临床表现、影像学、病理结果及预后情况。结果 407例患者中男女比为1∶1.22;发病年龄1岁1个月81岁。临床表现多为腹胀、腹痛、腹水和肝肿大。典型的腹部CT表现为肝肿大,增强后呈"地图状"或斑片状改变。病理可见肝窦扩张淤血,肝小静脉不同程度狭窄。407例患者中治疗有效302例,死亡90例,病死率22.11%。结论我国吡咯碱致肝窦阻塞综合征发病女性高于男性,任何年龄均可发生,以腹胀、腹痛、腹水和肝肿大为突出临床表现,结合典型的肝脏CT表现可明确诊断,肝穿刺病理表现为诊断金标准。治疗上以对症治疗为主,部分患者预后较差。

     

  • [1]Cooperative Group for Hepatic and Gall Diseases, Chinese Society of Gastroenterology, Chinese Medical Association.Expert consensus on diagnosis and treatment of quinazoline alkaloids-related sinusoidal obstruction syndrome (2017, Nanjing) [J].J Clin Hepatol, 2017, 33 (9) :1627-1637. (in Chinese) 中华医学会消化病分会肝胆疾病协作组.吡咯生物碱相关肝窦阻塞综合征诊断和治疗专家共识意见 (2017年, 南京) [J].临床肝胆病杂志, 2017, 33 (9) :1627-1633.
    [2]DIGNAN FL, WYNN RF, HADZICH N, et al.BCSH/BSBMT guideline:Diagnosis and management of veno-occlusive disease (sinusoidal obstruction syndrome) following haematopoietic stem cell transplantation[J].Br J Haematol, 2013, 163 (4) :444-457.
    [3]LI HN, ZHANG M.Research advances in sinusoidal obstruction syndrome[J].J Clin Hepatol, 2016, 32 (7) :1429-1432. (in Chinese) 厉海妮, 张民.肝窦阻塞综合征的研究进展[J].临床肝胆杂志, 2016, 32 (7) :1429-1432.
    [4]DALLE JH, GIRALT SA.Hepatic veno-occlusive disease after hematopoietic stem cell transplantation:Risk factors and stratification, prophylaxis, and treatment[J].Biol Blood Marrow Transplant, 2016, 22 (3) :400-409.
    [5]CHEN Z, HUO JR.Hepatic veno-occlusive disease associated with toxicity of pyrrolizidine alkaloids in herbal prearations[J].Neth J Med, 2010, 68 (6) :252-260.
    [6]WU YH, WU QH.Clinical characteristics of hepatic veno-occlusive disease by senecio chrysanthemoides:Analysis of 9 cases[J].China Med Herald, 2016, 13 (35) :161-163. (in Chinese) 吴玉华, 武谦虎.土三七致肝小静脉闭塞症9例临床分析[J].中国医药导报, 2016, 13 (35) :161-163.
    [7]WANG JY, GAO H.Tusanqi and hepatic sinusoidal obstruction syndrome[J].J Dig Dis, 2014, 15 (3) :105-107.
    [8]SONG Y, FAN YH.Clinical features of hepatic veno-occlusive disease induced by gynura root:analysis of 102 cases[J].J Clin Hepatol, 2011, 27 (5) :496-499. (in Chinese) 宋宇, 樊艳华.土三七所致肝小静脉闭塞病102例临床分析[J].临床肝胆病杂志, 2011, 27 (5) :496-499.
    [9] ZHANG YL.Sinusoidal obstruction syndrome in children[J].Chin Pediatr Emerg Med, 2012, 19 (4) :442-443. (in Chinese) 张艳玲.儿童肝窦阻塞综合征[J].中国小儿急救医学, 2012, 19 (4) :442-443.
    [10]CHEN Y, XU XG, CHEN F.Hepatic veno-occlusive disease in children:A case report and literature review[J].J Taishan Med Coll, 2017, 38 (6) :689-690. (in Chinese)
    [11]GAO H, RUAN JQ, CHEN J, et al.Blood pyrrole-protein adducts as a diagnostic and prognostic index in pyrrolizidine alkaloid-hepatic sinusoidal obstruction syndrome[J].Drug Des Devel Ther, 2015, 9:4861-4868.
    [12]LEE JH.Biomarkers for hepatic sinusoidal obstruction syndrome after hematopoietic cell transplantation[J].Blood Res, 2015, 50 (3) :123-125.
    [13]GUO W, SHI HP, MA XX.The diagnosis of sinusoidal obstruction syndrome based on CT findings[J/CD].Chin J Clinicians:Electronic Edition, 2012, 6 (13) :3722-3726. (in Chinese) 郭薇, 时惠平, 马晓璇.肝窦阻塞综合征CT诊断[J/CD].中华临床医师杂志:电子版, 2012, 6 (13) :3722-3726.
    [14]WU YF, LIU JH, ZHU BQ.Clinicopathological features of hepatic veno-occlusive disease:an analysis of 10 cases[J].Guide China Med, 2016, 14 (29) :110. (in Chinese) 吴云飞, 刘健红, 朱冰清, 等.10例肝窦阻塞综合征 (HVOD) 的临床病理分析[J].中国医药指南, 2016, 14 (29) :110.
    [15]SONG JS, SEO JJ, MOON HN, et al.Prophylactic low-dose heparin or prostaglandin E1 may prevent severe veno-occlusive disease of the liver after allogeneic hematopoietic stem cell transplantation in Korean children[J].J Korean Med Sci, 2006, 21 (5) :897-903.
    [16]IBRAHIM R, PERES E, DANSEY R, et al.Anti-thrombin in the management of hematopoietic stem-cell transplantation associated toxicity[J].Ann Pharmacother, 2004, 38 (6) :1053-1059.
    [17]RICHARDSON PG, HO VT, GIRALT S, et al.Safety and efficacy of defibrotide for the treatment of severe hepatic veno-occlusive disease[J].Ther Adv Hematol, 2012, 3 (4) :253-265.
    [18]RICHARDSON P, MURAKAMI C, JIN Z, et al.Multi-institutional use of defibrotide in 88 patients after stem cell transplantation with severe veno-occlusive disease and multisystem organ failure:Response without significant toxicity in a high-risk population and factors predictive of outcome[J].Blood, 2002, 100 (13) :4337-4434.
    [19]RICHARDSON PG, SMITH AR, TRIPLETT BM, et al.Defibrotide for patients with hepatic veno-occlusive disease/sinusoidal obstruction syndrome:Interim results from a treatment IND study[J].Biol Blood Marrow Transplant, 2017, 23 (6) :997-1004.
    [20]BAGAL B, CHANDRASEKHARAN A, CHOUGLE A, et al.Low, fixed dose defibrotide in management of hepatic veno-occlusive disease post stem cell transplantation[J].Hematol Oncol Stem Cell Ther, 2018, 11 (1) :47-51.
    [21]HELMY A.Review article:updates in the pathogenesis and therapy of hepatic sinusoidal obstruction syndrome[J].Aliment Pharmacol Ther, 2006, 23 (1) :11-25.
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  • 收稿日期:  2017-11-21
  • 出版日期:  2018-06-20
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