591例肝硬化患者门静脉血栓形成的危险因素分析

 目的  研究内镜治疗预防肝硬化食管胃静脉曲张再出血患者门静脉血栓(portal vein thrombosis,PVT)形成的相关危险因素。方法  回顾性分析2008-2013年间就诊于复旦大学附属中山医院消化科行内镜治疗预防食管胃静脉曲张再出血的肝硬化患者,收集相关临床资料,对可能影响PVT形成的因素进行单因素分析和多因素Logistic回归分析。结果  研究共纳入患者591名,分为PVT组(n=122,20.64%)和无PVT组(n=469,79.36%)。单因素分析显示两组间MELD评分、血红蛋白、血小板计数、总胆红素、丙氨酸氨基转移酶、血尿素氮、切脾比例差异存在统计学意义(P<0.05)。多因素Logistic回归发现:MELD评分、血尿素氮降低、D 二聚体升高、脾脏切除史是与PVT形成相关的独立危险因素(P值分别为0.016,0.026,0.014和<0.001)。结论  肝硬化患者应定期随访MELD评分、肝功能、D 二聚体水平及腹部超声,对有脾脏切除史的患者需给予更高警惕。

Risk factor analysis for portal vein thrombosis in 591 patients with liver cirrhosis

Objective  To observe the risk factors for portal vein thrombosis (PVT) in cirrhotic patients prior to receiving endoscopic treatment to prevent gastroesophageal varices rebleeding.Methods  A retrospective analysis was conducted on cirrhotic patients admitted to Zhongshan Hospital,Fudan University from 2008 to 2013 for secondary prevention of gastroesophageal varices bleeding via endoscopic treatment.Relevant information and data were collected,followed by an univariate analysis and multiple Logistic regression analysis in attempt to identify potential factors affecting the formation of PVT.Results  Totally 591 patients were enrolled in the present study and were classified as present-PVT group (n=122,20.64%) and absent-PVT group (n=469,79.36%).Univariate analysis showed that MELD score,hemoglobin,platelet count,total bilirubin,alanine aminotransferase,blood urea nitrogen,splenectomy ratio all achieved statistical significance between the two groups (P<0.05).The multiple Logistic regression showed that MELD score,lowered blood urea nitrogen,elevated D dimer and history of splenectomy were independent factors associated with the formation of PVT (P values were separately 0.016,0.026,0.014 and <0.001).Conclusions  Cirrhotic patients should receive regular surveillance for MELD score,liver function,D dimer and portal vein ultrasonography,especially in patients received with a previous history of splenectomy.