| 引用本文: | 杨姣姣,吴嘉勋,朱壹澎,李敏,任笑盈,卢高峰.肝硬化合并门静脉血栓的临床表现及危险因素分析[J].中国临床新医学,0,():-. |
| YANG Jiao-jiao,WU Jia-xun,ZHU Yi-peng,LI Min,REN Xiao-ying,LU Gao-feng.肝硬化合并门静脉血栓的临床表现及危险因素分析[J].中国临床新医学,0,():-. |
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| 肝硬化合并门静脉血栓的临床表现及危险因素分析 |
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杨姣姣, 吴嘉勋, 朱壹澎, 李敏, 任笑盈, 卢高峰
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郑州大学第二附属医院消化内科
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| 摘要: |
| 目的 分析肝硬化合并门静脉血栓（PVT）患者的临床表现及相关危险因素。方法：选取2012年10月至2018年10月在郑州大学第二附属医院诊治的肝硬化合并PVT患者59例（PVT组），随机选取同期住院的肝硬化未合并PVT患者78例作为对照（非PVT组）。收集患者的一般临床资料、实验室检查、影像学检查、临床表现及并发症情况等。比较两组患者的临床特点并分析出其相关影响因素。结果：两组血小板计数、平均血小板体积、血小板分布宽度、D-二聚体、纤维蛋白原、门静脉主干内径、脾厚、脾长、脾静脉内径、食管套扎术史、胃底硬化剂注射史、脾切除史差异有统计学意义（P<0．05）。二分类Logistic回归分析结果显示血小板计数增多（OR=1.014，P=0．008）、脾静脉内径增宽（OR=1.959，P=0．000）、脾脏厚度增加(OR=1.117，P=0．012）、有脾切史（OR=4.559，P=0.001）是肝硬化患者PVT独立危险因素。ROC曲线分析显示，脾静脉内径、血小板计数、脾脏厚度在诊断肝硬化合并PVT的AUC分别为0.725、0.640、0.595，脾静脉内径指标的诊断价值最高。腹胀、消化道出血、发热、腹水、肝性脑病的发生率在两组间比较差异无统计学意义（P>0.05），而腹痛的发生率差异有统计学意义（P<0．05）。结论：脾静脉内径增宽、血小板计数增加、脾脏增厚、脾切除史是肝硬化合并门静脉血栓形成的独立危险因素，门静脉血栓形成可加重肝硬化患者的临床症状及相关并发症的发生率增加。 |
| 关键词: 肝硬化 门静脉血栓 临床表现 危险因素 |
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| 基金项目:河南省基础与前沿技术研究计划(162300410128) |
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| Clinical features of liver cirrhosis complicated by portal vein thrombosis and related risk factors |
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YANG Jiao-jiao, WU Jia-xun, ZHU Yi-peng, LI Min, REN Xiao-ying, LU Gao-feng
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Department of Gastroenterology,The Second Affiliated Hospital of Zhengzhou University
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| Abstract: |
| ObjectiveTo analyze the clinical features of patients with liver cirrhosis complicated with portal vein thrombosis (PVT)and related risk factors. MethodsA total of 59 patients with liver cirrhosis complicated with PVT whowerediagnosedandtreated at the Second Affiliated Hospital of Zhengzhou University from October 2012 to October 2018 were enrolled as PVT group,and 78 cirrhotic patients without PVT were enrolled as controls(non-PVT group). The data collected include general clinical information, results of laboratory examination, imaging findings, clinical presentationsand complications . The clinical characteristics were compared between the two groups of patients and relevant influencing factors were analyzed. Results There were significant differences in platelet, mean platelet volume, platelet distribution width, D-dimer, fibrinogen, portal vein diameter, spleen thickness, spleen length,the diameter of the spleen vein, the history of esophageal ligation and injection of gastric fundus sclerosing agent, and the history of splenectomy(P<0.05)between these two groups. The results of two classification logistic regression analysis indicated that platelets(OR=1.014, P=0.008), inner diameter of the spleen vein (OR=1.959, P=0.000), spleen thickness (OR=1.117, P=0.012) , the history of splenectomy (OR=4.559,P=0.001)were independent riskfactors of PVT in patients with liver cirrhosis.ROC curve analysis indicated that the AUC of the spleen vein diameter, platelet count, and spleen thickness in the diagnosis of liver cirrhosis complicated with PVT were 0.725, 0.640, and 0.595, respectively.The diagnostic value of spleen vein diameter index is the highest.There was no significant difference in the incidence of abdominal distension, gastrointestinal bleeding, fever, ascites, and hepatic encephalopathy (P>0.05) between the two groups.,but showed significant differences in the incidence of abdominal pain (P<0.05). ConclusionThe inner diameter of the splenic vein, platelet count, the thickening of the spleen and the history of splenectomy are independent risk factors of PVT in patients with liver cirrhosis. The portal vein thrombosis can aggravate the clinical symptoms and increase the incidence of related complications in patients with liver cirrhosis. |
| Key words: Liver cirrhosis Portal vein thrombosis Clinical characteristics Risk factor |
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