Abstract: Analysis of risk factors for recurrence in patients with Budd-Chiari syndrome complicated by thrombus in inferior vena cava after interventional therapy        DANG Xiao-wei, WANG Pei-ju, LI Lu-hao,et al. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhengzhou University;Budd-Chiari Syndrome Diagnosis and Treatment Center of Henan Province, Zhengzhou 450052, China
Corresponding author：DANG Xiao-wei, E-mail：dangxw1001@163.com
Abstract    Objective    To analyze the recurrence in patients with Budd-Chiari syndrome（B-CS）complicated by thrombus in inferior vena cava（IVC）after interventional therapy，and to explore the risk factors. Methods    A total of 79 patients with B-CS complicated by IVC thrombus who received interventional therapy in the First Affiliated Hospital of Zhengzhou University from October 2015 to October 2020 were retrospectively analyzed and followed up. Kaplan-Meier analysis were used to calculate the recurrence rate of patients after intervention and draw the recurrence curve，and Cox regression analysis were used to explore the risk factors affecting recurrence. Results    42 patients had recurrence after operation.The 6 months，1，2，3，5-year cumulative recurrence rate of IVC were 24.3%，32.5%，51.0%，56.5%，and 69.7% respectively. 36 recurrent patients received therapy again，of which 14 cases had obstruction of IVC. The 14 cases’cumulative recurrence rates of 6 months，1，2 -year after operation were 7.1%，15.6% and 26.1% respectively. Another 22 cases were complicated with thrombosis，the cumulative recurrence rates reached 14.3%，33.3% and 38.9%. Based on the multivariate analysis，length of IVC obstruction，the number of type-A accessory hepatic veins，the types of oral anticoagulants，platelet count，albumin and NewClichy index were independent risk factors for recurrence（P˂0.01）.Conclusion    There is a high recurrence rate after intervention in B-CS complicated by IVC thrombus.Multiple factors affect the recurrence.Regular reexamination and early intervention will improve the prognosis of patients.

Key words: Budd-Chiari syndrome, inferior vena cava thrombosis, interventional therapy, recurrence, risk factors

摘要： 目的    分析布-加综合征（B-CS）合并下腔静脉（IVC）血栓病人介入开通后的复发情况，并探讨其危险因素。方法    回顾性分析2015年10月至2020年10月在郑州大学第一附属医院接受介入治疗的79例B-CS合并IVC血栓病人临床资料并进行随访，使用Kaplan-Meier法计算术后复发率并绘制复发曲线，对影响复发的危险因素进行Cox回归分析。结果    42例病人于首次术后出现复发，6个月、1年、2年、3年、5年的累积复发率分别为24.3%、32.5%、51.0%、56.5%、69.7%。36例复发病人再次接受了介入治疗，其中14例IVC阻塞病人二次术后6个月、1年、2年的累积复发率分别为7.1%、15.6%、26.1%；另外22例合并血栓形成的病人二次术后累计复发率为14.3%、33.3%、38.9%。多因素Cox回归分析显示IVC阻塞段长度、A类副肝静脉数目、口服抗凝药类别、血小板计数、血清白蛋白、New Clichy指数是病人复发的独立危险因素（P值均＜0.01）。结论    B-CS合并IVC血栓的介入术后复发率较高并受多种因素影响，定期复查、尽早干预能够改善病人预后。

关键词: 布-加综合征, 下腔静脉血栓, 介入治疗, 复发, 危险因素