肝硬化并发门静脉血栓危险因素的Logistic回归分析

目的 探讨肝硬化并发门静脉血栓(PVT)形成的危险因素。方法 2012年3月~2016年12月收治444例肝硬化患者,其中并发PVT者44例,无PVT者400例。收集并对比两组患者的临床资料。采用t检验或x²检验进行危险因素的单因素分析,采用非条件多因素Logistic回归模型进行独立危险因素分析。结果 单因素分析显示,PVT组与无PVT组患者在Child-Pugh评分（7.65±2.01对6.90±1.85）、血红蛋白（HB）、血小板（PLT）、D-二聚体、纤维蛋白原降解产物（FDP）、白蛋白、门静脉内径、脾脏长径、脾脏厚径、门静脉流速和糖尿病发生率方面比较差异均具有统计学意义（均P<0.05）;多因素Logistic回归分析结果显示:门静脉内径（OR=1.258,95%CI 1.035~1.616,P=0.009）、D-二聚体（OR=3.915,95%CI 2.243~5.796,P=0.000）和糖尿病（OR=4.189,95%CI 2.067~6.231,P=0.000）是肝硬化并发PVT形成的独立危险因素。结论 影响肝硬化并发PVT发生的因素众多,其中血D-二聚体水平升高、门静脉内径增宽和伴有糖尿病是其独立危险因素,应给予充分的重视。

Logistic regression analysis on the risk factors of portal vein thrombosis in patients with liver cirrhosis

Objective To explore the risk factors of portal vein thrombosis（PVT） occurrence in patients with liver cirrhosis. Method The clinical data of 444 patients with liver cirrhosis recruited in our hospital between March and December 2016 were retrospectively analyzed. Out ot them,44 had PVT,and 400 without. The clinical data in the two groups were collected and compared. The t-test or Chi-square test was used to analyze the risk factors for PVT,and univariate and multivariate Logistic regression model were applied to analyze the independent risk factors. Results Univariate analysis showed that there were significant differences as respect to Child-Pugh score,hemoglobin （HB）,platelet（PLT）,D-dimer,fibrinogen degradation product （FDP）,albumin （ALB）,portal vein diameter,spleen length,spleen thickness,portal vein flow rate and the incidence of diabetes between the two groups （P<0.05）;multivariate Logistic regression analysis showed that portal vein diameter （OR=1.258,95%CI 1.035~1.616,P=0.009）,D-dimer（OR=3.915,95%CI 2.243~5.796,P=0.000）,and diabetes （OR=4.189,95%CI 2.067~6.231,P=0.000） were the independent risk factors for the formation of PVT. Conclusion There are many factors influencing the occurrence of PVT,whereas increased blood D-dimer levels,widened portal vein diameter and diabetes are the independent risk factors in patients with liver cirrhosis. which should be taken into consideration in clinical practice.