肝硬化门静脉血栓形成危险因素的Meta分析  

Risk factors for portal vein thrombosis in cirrhotic patients:A meta-analysis

作　　者：李陈婕[1] 羊志辉[2] 施小六[1] 卢放根[1] 刘德良[1] 

机构地区：[1]中南大学湘雅二医院消化内科,湖南省长沙市410011 [2]国防科技大学医院干部保健科,湖南省长沙市410073

出　　处：《世界华人消化杂志》2017年第3期241-251,共11页World Chinese Journal of Digestology

摘　　要：目的为探讨肝硬化门静脉血栓形成(portal vein thrombosis,PVT)的危险因素而进行了Meta分析.方法应用Meta分析的方法 ,对有关肝硬化PVT的危险因素相关的9篇文献进行综合分析,计算各个可疑危险因素的合并比值比或加权均数差值(weighted mean difference,WMD)及其95%可信区间(95%confidence interval,95%CI).计算机检索Pub Med、CNKI、万方等数据库,检索时间截止2015-08,并辅以文献追溯等方法 .纳入有关肝硬化PVT危险因素的病例对照研究,并进行文献质量评价.采用Cochrane图书馆的Rev Man5.0软件进行Meta分析.结果纳入9篇符合标准的病例对照研究,病例数为1105例.其中血栓组269例.Meta分析结果显示,肝硬化PVT与D-二聚体(WMD=0.34,95%C I:0.21-0.46)、门静脉直径(WMD=1.67,95%C I:1.36-1.97)、门静脉血流速度[WMD=-2.32,95%CI:-3.63-(-1.01)]及脾脏厚度(WMD=8.57,95%CI:4.14-12.99)有关;而与患者的性别、年龄、血小板计数(blood platelet,PLT)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)及纤维蛋白原(fi brinogen,FIB)无关.结论肝硬化PVT的主要危险因素为D-二聚体、门静脉直径、门静脉血流速度及脾脏厚度,与患者性别、年龄、PLT、PT、APTT、FIB无直接相关性.AIM To identify the risk factors for portal vein thrombosis（PVT） in cirrhotic patients.METHODS We searched the PubMed,CNKI and Wanfang Databases up to Aug 2015 to retrieve casecontrolled studies about the risk factors for PVT in cirrhotic patients for meta-analysis.The odds ratio or weighted mean difference（WMD）of each risk factor was estimated and the 95%confidence interval（95%CI） was calculated.RevMan 5.0 software provided by the Library of Cochrane was used for meta-analysis.RESULTS Nine case-controlled studies were included.The risk factors for PVT included D-dimer（WMD = 0.34,95%CI：0.21-0.46）,portal vein diameter（WMD = 1.67,95%CI：1.36-1.97）,portal venous flow[WMD =-2.32,95%CI：-3.63-（-1.01）],and splenic thickness（WMD= 8.57,95%CI：4.14-12.99）.There were no significant differences between patients with and without PVT in terms of sex,age,platelet,prothrombin time,activated partial thromboplastin time,and fibrinogen.CONCLUSION The risk factors for PVT in cirrhotic patients include D-dimer,portal vein diameter,portal venous flow,and splenic thickness.

关 键 词：肝硬化 门静脉血栓 危险因素 META分析 

分 类 号：R575.21[医药卫生—消化系统]