肝硬化并发门静脉血栓的风险因素及预测模型构建  

Risk factors and predictive model construction of portal vein thrombosis in pa-tients with liver cirrhosis

作　　者：贾锋[1] 吴玉卓[2] 孙晓林[3] 朱晓娟[1] 聂磊 JIA Feng;WU Yuzhuo;SUN Xiaolin;ZHU Xiaojuan;NIE Lei(Department of General Surgery,Nanyang Central Hospital,Nanyang 473000,China;Department of infectious diseases,Nanyang Central Hospital,Nanyang 473000,China;Department of Nursing,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院普外科,南阳473000 [2]南阳市中心医院感染性疾病科,南阳473000 [3]南阳市中心医院护理部,南阳473000

出　　处：《西南医科大学学报》2024年第5期415-419,共5页Journal of Southwest Medical University

基　　金：河南省医学科技攻关计划联合共建项目(LHG 20191458)。

摘　　要：目的探讨肝硬化患者并发门静脉血栓(portal veinthrombosis,PVT)的影响因素,并建立肝硬化患者并发PVT的风险预测模型。方法选择2021年1月至2022年11月在南阳市中心医院治疗的139例肝硬化患者为研究对象,将其中并发PVT形成的32例患者作为PVT组,将未并发PVT的107例患者作为非PVT组,收集患者临床资料,采用logistic回归模型分析肝硬化患者并发PVT形成的危险因素,危险因素采用R(R3.5.3)软件建立预测肝硬化患者并发PVT形成的列线图风险预测模型,并验证其预测效能。结果PVT发生率为23.02%;两组患者糖尿病、高血压、脾切除史、纤维蛋白原(fibrinogen,FIB)、白细胞(white bloodcells,WBC)、门静脉主干内径等资料对比差异具有统计学意义(P<0.05)。多因素结果显示,伴有糖尿病、高血压、脾切除史,FIB表达降低、WBC表达升高、门静脉主干内径增加均为肝硬化患者并发PVT形成的独立危险因素(P<0.05)。基于危险因素所构建的列线图模型的模型一致性指数为0.920,校正曲线与理想曲线基本一致,AUC值为0.897。结论伴有糖尿病、高血压、脾切除史,FIB水平降低、WBC水平升高、门静脉主干内径增加均为肝硬化患者并发PVT形成的独立危险因素,基于上述因素构建的列线图模型有助于临床预测肝硬化并发门静脉血栓形成的发生风险。Objective To investigate the influencing factors of portal vein thrombosis(PVT)in patients with cirrhosis,and to es-tablish a risk prediction model of PVT in patients with cirrhosis.Methods A total of 139 patients with cirrhosis treated in Nanyang Cen-tral Hospital from January 2021 to November 2022 were selected as the study objects.A total of 32 patients with PVT complications were selected as the PVT group,while a total of 107 patients without PVT complications were selected as the non-PVT group.Clinical data of the patients were collected.logistic regression model was used to analyze the risk factors for the formation of PVT in patients with cirrhosis.The risk factors were analyzed by using R(R3.5.3)software to establish a risk prediction model for predicting the formation of PVT in patients with cirrhosis and verify its prediction efficiency.Results In this study,the incidence of PVT was 23.02%.Data of dia-betes,hypertension,splenectomy history,Fibrinogen(FIB),White blood cells(WBC)and portal vein main diameter were compared between the two groups(P<0.05).Multivariate results showed that diabetes mellitus,hypertension,splenectomy history,decreased FIB expression,increased WBC expression,and increased portal vein main diameter were independent risk factors for PVT in patients with cirrhosis(P<0.05).The consistency index of a Nomogram model based on risk factors was 0.920,the corrected curve was basi-cally consistent with the ideal curve,and the AUC value was 0.897.Conclusion Diabetes mellitus,hypertension,splenectomy history,decreased FIB level,increased WBC level,and increased portal vein internal diameter were all independent risk factors for patients with cirrhosis complicated with PVT.The line graph model constructed based on the above factors was helpful for clinical prediction of the risk of portal vein thrombosis in cirrhosis.

关 键 词：肝硬化 静脉血栓 危险因素 预测模型 列线图 

分 类 号：R575[医药卫生—消化系统]