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摘要：
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摘要：目的 分析草药土三七致肝小静脉闭塞症（hepatic vero-occlusive disease，HVOD）的临床特点
及预后。方法 回顾性分析首都医科大学附属北京地坛医院2007年1月至2018年5月确诊的12例土三七
致HVOD患者的临床资料，根据临床进展及肝损害程度分为肝功能衰竭组（5例）及非肝功能衰竭
组（7例），比较两组患者临床及实验室特点。结果 12例患者中男性8例，女性4例，平均（56.41 ±
14.18）岁，多数因保健、月经不调、骨折、腰腿痛及腰椎间盘突出等服用土三七药粉或代茶饮、药
酒等。腹部CT或MRI具有“地图状”或“云絮状”不均匀强化灶、肝静脉显示不清等特征性影像特
点。随着疾病进展，肝功能衰竭组患者AST和TBil显著高于非肝功能衰竭组，ALB和PTA显著低于非
肝功能衰竭组，差异有统计学意义（P ＜ 0.05）。结论 结合服药史、CT/MRI特征性影像及肝脏病理
有助于土三七诱发HVOD的确诊。病情进展迅速导致肝功能衰竭可能与服用土三七总剂量及疗程有
关。土三七引起的肝功能衰竭预后较差。
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Abstract: Objective To analyze the clinical characteristics and prognosis of hepatic veno-occlusive disease
(HVOD) induced by gynura segetum. Methods The clinical data of 12 patients with hepatic veno-occlusive
syndrome induced by gynura segetum in Beijing Ditan Hospital, Capital Medical University from January
2007 to May 2018 were retrospectively analyzed. The patients were divided into liver failure group (5 cases)
and non liver failure group (7 cases) according to the clinical progress and the degree of liver injury. Results
Among the 12 patients, 8 cases were male and 4 cases were female, the average age was (56.41 ± 14.18)
years old. Most patients had taken gynura segetum powder or substitute tea, medicinal wine and so on due to
health care, irregular menstruation, fracture, lumbago and leg pain, lumbar disc protrusion and other diseases.
The characteristic imaging features of abdominal CT or MRI were “map-like” or “cloudy floccus” uneven
enhancement focus and unclear hepatic vein display. With the progression of the disease, the levels of AST
and TBil in liver failure group were significantly higher than those in non-liver failure group, while the levels
of ALB and PTA were significantly lower (P ＜ 0.05). Conclusions Combined with the history of drug use,
CT/MRI features and liver pathology is helpful for the diagnosis of HVOD induced by gynura segetum. The
severity of the disease may be related to the basic diseases and the total dose or course of gynura segetum
therapy. The prognosis of hepatic failure caused by gynura segetum is poor.
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