肝硬化合并门脉血栓形成的危险因素分析
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摘要
目的:探讨肝硬化合并门脉血栓形成(PVT)的危险因素。方法:选取88例肝硬化合并PVT患者(简称为PVT组)和肝硬化未合并PVT的患者88例为对照组,统计分析两组患者的一般资料、实验室相关检查指标,采用多因素分析法探讨肝硬化并发PVT的危险因素。结果:两组患者的年龄、性别、基础病因、合并高血压、合并糖尿病、WBC、PLT、TBil、INR、APTT、FIB、PT、MELD评分差异无统计学意义(P> 0. 05); PVT组患者的Hb、Alb、D-D、门静脉主干内径宽度、脾静脉内径宽度与对照组比较差异具有统计学意义(P <0. 05);采用非条件Logistic回归分析结果显示:Hb和Alb降低、D-D升高、门静脉主干内径宽度、脾静脉内径宽度增加是肝硬化患者并发PVT的独立危险因素(P <0. 05)。结论:Hb和Alb降低、D-D升高、脾静脉内径宽度增加是肝硬化患者并发PVT的独立危险因素。
Objective: To explore the risk factors of cirrhosis with portal vein thrombosis(PVT). Methods: 88 cases of cirrhosis with PVT(PVT group) were selected. From January 2014 to September 2016,88 patients with co-cirrhosis without PVT were selected. The general data of the two groups were analyzed statistically. The risk factors of cirrhosis complicated with PVT were investigated by multivariate analysis. Results: PVT group and control group in age,gender,underlying disease,hypertension,diabetes,WBC,PLT,TBil,INR,APTT,FIB,PT,MELD score difference were statistically significant(P > 0. 05); the difference were statistically significant in PVT group were Hb,Alb,D-D,portal vein diameter,width the width of splenic vein and the control group(P < 0. 05); using non conditional Logistic regression analysis showed that Hb decreased,ALB decreased,D-D increased,the diameter of splenic vein width were independent risk factors in patients with liver cirrhosis complicated with PVT(P < 0. 05). Conclusion: The decrease of Hb,the decrease of Alb,the elevation of D-D and the increase of the width of splenic vein were the independent risk factors of PVT in patients with cirrhosis.
Objective: To explore the risk factors of cirrhosis with portal vein thrombosis(PVT). Methods: 88 cases of cirrhosis with PVT(PVT group) were selected. From January 2014 to September 2016,88 patients with co-cirrhosis without PVT were selected. The general data of the two groups were analyzed statistically. The risk factors of cirrhosis complicated with PVT were investigated by multivariate analysis. Results: PVT group and control group in age,gender,underlying disease,hypertension,diabetes,WBC,PLT,TBil,INR,APTT,FIB,PT,MELD score difference were statistically significant(P > 0. 05); the difference were statistically significant in PVT group were Hb,Alb,D-D,portal vein diameter,width the width of splenic vein and the control group(P < 0. 05); using non conditional Logistic regression analysis showed that Hb decreased,ALB decreased,D-D increased,the diameter of splenic vein width were independent risk factors in patients with liver cirrhosis complicated with PVT(P < 0. 05). Conclusion: The decrease of Hb,the decrease of Alb,the elevation of D-D and the increase of the width of splenic vein were the independent risk factors of PVT in patients with cirrhosis.
引文
[1]林国帅,徐琴,赵淑一,等.肝硬化合并门静脉血栓形成的临床特点及其相关危险因素分析[J].中华肝脏病杂志,2016,24(7):513-517.
[2]刘熙瑞,刘连新.肝硬化门静脉高压症脾切除术后门静脉血栓形成的研究进展[J].中华消化外科杂志,2015,14(2):170-172.
[3]中华医学会肝病学会分会.病毒性肝炎防治方案[J].中华肝脏病杂志,2015,19(5):1-19.
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[7]刘金芝,胡乃中,许建明.肝硬化合并门静脉血栓形成危险因素及预后研究[J].安徽医科大学学报,2016,51(2):280-283.
[8]贺莎莎,范晓棠,石绣江,等.肝硬化门静脉高压症脾切除术后发生门静脉血栓的风险因素及其预测模型的建立[J].中国普通外科杂志,2016,25(12):1766-1772.
[9]李大伟.血浆D-二聚体对腹腔镜脾切除门奇静脉断流术后门静脉血栓形成的预测意义[J].中国普通外科杂志,2014,23(2):207-211.
[10]陈小刚,张培瑞,李志伟,等.肝硬化门静脉高压脾切断流术后影响门静脉系统血栓形成的因素[J].中国普通外科杂志,2013,22(1):67-70.
[11]卢翔,赵青川,韩国宏,等.肝硬化门静脉高压症术后门静脉血栓形成危险因素研究[J].中国实用外科杂志,2013,8(3):205-207.
[12]童秀萍,洪小飞,吴深宝,等.肝硬化合并感染患者的临床研究及危险因素分析[J].中华医院感染学杂志,2013,23(6):1317-1318.
[13]武国,李建水,陶涛,等.门静脉高压症术后门静脉血栓形成的危险因素分析[J].重庆医科大学学报,2012,37(4):376-378.
[14]汤雯,贾继东.肝硬化患者门静脉血栓形成的发病机制及诊断进展[J].中华肝脏病杂志,2015,23(7):550-552.
[15]王满才,田斌,王根年,等.肝硬化脾切除术后门静脉血栓形成相关因素的Meta分析[J].中华肝胆外科杂志,2014,20(12):855-861.
[16]吕少诚,顾万清.肝硬化患者脾切除术后门静脉血栓的防治研究进展[J].中华肝胆外科杂志,2015,21(1):59-62.
[17]吕云福,刘宁,张世杰,等.肝硬化门静脉高压症手术预后的危险因素[J].中华肝胆外科杂志,2012,18(4):278-282.
[2]刘熙瑞,刘连新.肝硬化门静脉高压症脾切除术后门静脉血栓形成的研究进展[J].中华消化外科杂志,2015,14(2):170-172.
[3]中华医学会肝病学会分会.病毒性肝炎防治方案[J].中华肝脏病杂志,2015,19(5):1-19.
[4]中华医学会肝病学会酒精性肝病学组.酒精性肝病治疗指南2010年版[J].中华内科杂志,2010,49(4):617-622.
[5]周磊,孔德润.肝硬化合并门静脉血栓形成的危险因素分析[J].安徽医科大学学报,2014,49(10):1505-1507.
[6]张莉,王龙,杨根妹.肝硬化门静脉血栓形成的相关危险因素分析[J].中华消化杂志,2014,34(2):100-104.
[7]刘金芝,胡乃中,许建明.肝硬化合并门静脉血栓形成危险因素及预后研究[J].安徽医科大学学报,2016,51(2):280-283.
[8]贺莎莎,范晓棠,石绣江,等.肝硬化门静脉高压症脾切除术后发生门静脉血栓的风险因素及其预测模型的建立[J].中国普通外科杂志,2016,25(12):1766-1772.
[9]李大伟.血浆D-二聚体对腹腔镜脾切除门奇静脉断流术后门静脉血栓形成的预测意义[J].中国普通外科杂志,2014,23(2):207-211.
[10]陈小刚,张培瑞,李志伟,等.肝硬化门静脉高压脾切断流术后影响门静脉系统血栓形成的因素[J].中国普通外科杂志,2013,22(1):67-70.
[11]卢翔,赵青川,韩国宏,等.肝硬化门静脉高压症术后门静脉血栓形成危险因素研究[J].中国实用外科杂志,2013,8(3):205-207.
[12]童秀萍,洪小飞,吴深宝,等.肝硬化合并感染患者的临床研究及危险因素分析[J].中华医院感染学杂志,2013,23(6):1317-1318.
[13]武国,李建水,陶涛,等.门静脉高压症术后门静脉血栓形成的危险因素分析[J].重庆医科大学学报,2012,37(4):376-378.
[14]汤雯,贾继东.肝硬化患者门静脉血栓形成的发病机制及诊断进展[J].中华肝脏病杂志,2015,23(7):550-552.
[15]王满才,田斌,王根年,等.肝硬化脾切除术后门静脉血栓形成相关因素的Meta分析[J].中华肝胆外科杂志,2014,20(12):855-861.
[16]吕少诚,顾万清.肝硬化患者脾切除术后门静脉血栓的防治研究进展[J].中华肝胆外科杂志,2015,21(1):59-62.
[17]吕云福,刘宁,张世杰,等.肝硬化门静脉高压症手术预后的危险因素[J].中华肝胆外科杂志,2012,18(4):278-282.