肝硬化门静脉高压并发脾动脉瘤的危险因素分析

Risk factors analysis of portal hypertension with cirrhosis complicated with splenic artery aneurysms

目的探讨肝硬化门静脉高压患者并发脾动脉瘤的相关危险因素。方法回顾性分析郑州大学第一附属医院2014年5月至2016年8月收治的10例肝硬化门静脉高压并发脾动脉瘤患者的临床资料。随机选取同期收治的60例肝硬化门静脉高压未并发脾动脉瘤患者作为对照组。分析两组患者的年龄、性别、吸烟史、饮酒史、高血压史、糖尿病史、肝炎史、Child-Pugh评分、血常规、肝功能、凝血功能、门静脉主干内径、肝动脉主干内径、脾动脉主干内径、脾静脉主干内径、脾脏厚度及脾脏长径,采用单因素分析及非条件Logistic回归模型筛选肝硬化门静脉高压并发脾动脉瘤的危险因素。结果单因素分析显示,脾动脉瘤组与非脾动脉瘤组患者年龄、性别、吸烟史、饮酒史、高血压史、糖尿病史、肝炎史、Child-Pugh评分、血常规、肝功能、凝血功能、门静脉主干内径、脾脏厚度及脾脏长径相比,差异均无统计学意义(P>0.05)。脾动脉瘤组患者的肝动脉主干内径明显小于非脾动脉瘤组患者,而脾动脉主干内径及脾静脉主干内径明显大于非脾动脉瘤组患者,差异有统计学意义(P<0.05)。非条件Logistic回归模型分析结果显示,肝动脉主干内径及脾静脉主干内径是肝硬化门静脉高压并发脾动脉瘤的独立危险因素(OR值分别为21.064、0.254,P均<0.05)。结论肝硬化门静脉高压并发脾动脉瘤的发生可能与肝动脉主干内径缩小、脾动脉主干内径及脾静脉主干内径增加有关,肝动脉主干内径及脾静脉主干内径是其独立危险因素。

Objective artery aneurysms. Methods To investigate the risk factors of portal hypertension with cirrhosis complicated with splenic The clinical data of 10 patients with portal hypertension with cirrhosis complicated with splenic artery aneurysms treated in the First Affiliated Hospital of Zhengzhou University from May. 2014 to Aug. 2016 were retrospectively analyzed. Sixty patients with portal hypertension with cirrhosis treated in the same study period were selected randomly to form a control group. The age, gender, smoking history, drinking history, hypertension history, di- abetes history, hepatitis history, Child-Pugh score, blood routine, liver function, coagulation function, portal vein di- ameter, hepatic artery diameter, splenic artery diameter, splenic vein diameter, splenic length and splenic thickness were recorded and analyzed. Univariate analysis and unconditional Logistic regression model were performed to find out the risk factors. Results Univariate analysis showed that there were no statistical differences in age, gender, smoking history, drinking history, hypertension history, diabetes history, hepatitis history, Child-Pugh score, blood routine, liver function, coagulation function, portal vein diameter, splenic length and splenic thickness between two groups （P 〉 0.05 ）. The hepatic artery diameter in the splenic artery aneurysms group was obviously lower than that in the non-splenic artery aneurysms group, while the splenic artery diameter and splenic vein diameter in the splenic artery aneurysms group were obviously higher than those in the non-splenic artery aneurysms group （P 〈 0.05）. The results of uncondi- tional Logistic regression model analysis indicated that hepatic artery diameter and splenic vein diameter were independ- ent risk factors of portal hypertension with cirrhosis complicated with splenic artery aneurysms （ OR = 21. 064, 0.254, P 〈 0.05 ）. Conclusion Portal hypertension with cirrhosis complicated with splenic artery aneurysms is correlated with a discrease in hepatic artery diameter and an increase in splenic artery diameter and splenic vein diameter. Hepatic artery diameter and splenic vein diameter are independent risk factors.