肝硬化患者非肿瘤性门静脉血栓形成的相关危险因素分析  

Risk factors for non-neoplastic portal vein thrombosis in patients with liver cirrhosis

作　　者：刘天府[1] 王亮[1] 张岭漪[1] LIU Tianfu;WANG Liang;ZHANG Lingyi(Department of Hepatology,The Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院肝病科,兰州730030

出　　处：《临床肝胆病杂志》2023年第9期2122-2127,共6页Journal of Clinical Hepatology

基　　金：甘肃省教育科技创新项目(2022B-047);兰州大学第二医院“萃英科技创新”计划(CY2021-QN-A18)。

摘　　要：目的探讨肝硬化患者非肿瘤性门静脉血栓(PVT)形成的相关危险因素,筛选早期预测因子。方法纳入2021年7月1日—2022年6月30日于兰州大学第二医院肝病科住院治疗的肝硬化非肿瘤性PVT患者50例作为PVT组,随机抽取同期肝硬化无PVT患者100例作为对照组,收集相关临床资料。正态分布的计量资料两组间比较采用成组t检验;非正态分布的计量资料两组间比较采用Mann-Whitney U检验。计数资料两组间比较采用χ^(2)检验。应用多因素Logistic回归模型分析肝硬化发生PVT的影响因素。通过受试者工作特征曲线分析影响因素对PVT的预测效能。结果单因素分析结果显示,两组患者蛋白C、蛋白S、凝血酶原时间、国际标准化比值、纤维蛋白原、白细胞、血小板、生化指标等差异均无统计学意义(P值均>0.05);脾脏切除史、食管胃底静脉曲张内镜下治疗史、肝性脑病史、服用非选择性β受体阻滞剂(NSBB)以及D-二聚体(D-dimer)、血红蛋白和甘油三酯水平差异均有统计学意义(P值均<0.05)。多因素Logistic回归模型分析结果显示,D-dimer水平(OR=1.120,95%CI:1.006~1.246,P=0.038)、脾脏切除史(OR=9.320,95%CI:2.928~29.665,P<0.001)、肝性脑病史(OR=16.813,95%CI:1.808~156.336,P=0.013)和服用NSBB(OR=3.203,95%CI:1.020~10.051,P=0.046)是PVT形成的独立危险因素。结论D-dimer水平升高、脾脏切除史、肝性脑病史、服用NSBB是肝硬化患者非肿瘤性PVT形成的预测因子。Objective To investigate the risk factors for non-neoplastic portal vein thrombosis(PVT)in patients with liver cirrhosis and related early predictive factors.Methods A total of 50 cirrhotic patients with non-neoplastic PVT who were hospitalized and treated in Department of Hepatology,The Second Hospital of Lanzhou University,from July 1,2021 to June 30,2022 were enrolled as PVT group,and 100 cirrhotic patients without PVT who were treated during the same period of time were randomly selected as control group.Related clinical data were collected.The independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test was used for comparison of categorical data between two groups.A multivariate Logistic regression model analysis was used to investigate the influencing factors for PVT in liver cirrhosis,and the receiver operating characteristic curve was used to evaluate the predictive performance of influencing factors.Results The univariate analysis showed that there were no significant differences between the two groups in the indicators such as protein C,protein S,prothrombin time,international standardized ratio,fibrinogen,white blood cell count,platelet count,and biochemical parameters(all P>0.05),while there were significant differences between the two groups in history of splenectomy,history of endoscopic treatment of esophageal and gastric varices,history of hepatic encephalopathy,administration of non-selectiveβ-blocker(NSBB),D-dimer,hemoglobin,and triglyceride(all P<0.05).The multivariate Logistic regression model analysis showed that D-dimer(odds ratio[OR]=1.120,95%confidence interval[CI]:1.006-1.246,P=0.038),history of splenectomy(OR=9.320,95%CI:2.928-29.665,P<0.001),history of hepatic encephalopathy(OR=16.813,95%CI:1.808-156.336,P=0.013),and administration of NSBB(OR=3.203,95%CI:1.020-10.051,P=0.046)were independent risk factors

关 键 词：肝硬化 静脉血栓形成 危险因素 

分 类 号：R575.2[医药卫生—消化系统]