Abstract: Objective To analyze the relationship between preoperative serum alanine aspartate aminotransferase / aminotransferase (AST / ALT) ratio and prognosis of patients with Budd-Chiari syndrome (BCS). Methods Data of 280 patients with BCS admitted to the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. The median value of AST/ALT ratio (0.75) was used for grouping. There were 142 cases in group AST/ALT ratio ≤ 0.75 and 138 cases in group AST/ALT ratio > 0.75. All patients underwent interventional surgery and followed up for at least 5 years. According to the recurrence of follow-up results, the relationship between preoperative serum AST / ALT levels and recurrence was analyzed retrospectively. Results There were significant differences in gender, Child-Pugh grade of liver function and recurrence rate between the two groups. The mean vascular patency time were 45 (37, 52) and 40 (21, 49) months for AST/ALT ratio ≤ 0.75 group and AST/ALT ratio >0.75 group. The mean vascular patency time was significantly shorter in AST/ALT ratio > 0.75 group than that of AST/ALT ratio ≤ 0.75 group (Z=2.159，P＜0.05). The cumulative patency rates were 94.4%, 76.8% and 64.1%, respectively in AST / ALT ratio ≤0.75 group for 1, 3 and 5 years. The cumulative patency rates were 90.6%, 68.1% and 58.7% in AST/ALT ratio > 0.75 group for 1, 3 and 5 years, respectively. The 5-year cumulative patency rate was significantly lower in patients with AST/ALT>0.75 group than that of patients with AST/ALT≤ 0.75 group (Log-rank χ2=4.372，P＜0.05). Multivariate Cox regression analysis showed that the liver function of Child-Pugh classification (C) patients were easy to relapse BCS. Conclusion AST/ALT ratio is associated with recurrence of BCS after interventional therapy. Child-Pugh classification of liver function is an independent risk factor for the prognosis of BCS.

Key words: Budd-Chiari syndrome, alanine transaminase, aspartate aminotransferases, recurrence, risk factors, AST/ALT ratio