导致肝硬化患者发生门静脉血栓的危险因素

Risk factors of portal vein thrombosis in patient with liver cirrhosis

目的 :探讨导致肝硬化患者发生门静脉血栓(PVT)的危险因素。方法 :将合肥市第二人民医院消化内科接诊的25例肝硬化合并PVT患者作为PVT组,另选取同期该院接诊的55例未合并PVT的肝硬化患者作为无PVT组。对比两组患者的临床资料,从中找出导致肝硬化患者发生PVT的危险因素。结果 :PVT组患者门静脉的最大血流速度低于无PVT组患者,其门静脉的宽度宽于无PVT组患者,其脾脏的厚度厚于无PVT组患者,其Child-Pugh的评分、D-二聚体的水平均高于无PVT组患者,P <0.05。进行多因素Logistic回归分析的结果显示,门静脉的最大血流速度较低、门静脉的宽度及脾脏的厚度增加、Child-Pugh评分和D-二聚体的水平较高均为导致肝硬化患者发生门静脉血栓的危险因素。进行Pearson相关性分析的结果显示,肝硬化患者门静脉的最大血流速度与其门静脉的宽度及脾脏的厚度均呈负相关(r=-0.991,P=0.000;r=-0.977,P=0.000);肝硬化患者门静脉的最大血流速度与其D-二聚体的水平呈负相关(r=-0.986,P=0.000);肝硬化患者的Child-Pugh评分与其D-二聚体的水平呈正相关(r=0.979,P=0.000)。结论 :导致肝硬化患者发生门静脉血栓的危险因素主要包括门静脉的最大血流速度较低、门静脉的宽度及脾脏的厚度增加、Child-Pugh评分和D-二聚体的水平较高等。

objective： to investigate the risk factors of portal vein thrombosis （PVT） in patients with liver cirrhosis. Methods： 25 cases of liver cirrhosis with PVT treated in digestive department of hefei no.2 people＇ s hospital were selected as PVT group, and 55 cases of liver cirrhosis without PVT treated in the hospital during the same period were selected as PVT group. The clinical data of the two groups were compared to find out the risk factors of PVT in patients with cirrhosis. Results： the maximum blood flow velocity of portal vein in patients of PVT group was lower than that of patients without PVT group, the width of portal vein was wider than that of patients without PVT group, the thickness of spleen was thicker than that of patients without PVT group, and the child-pugh score and d-dimer level were higher than those of patients without PVT group, P 〈 0.05. The results of multivariate Logistic regression analysis showed that lower maximum flow velocity of portal vein, increased portal vein width and spleen thickness, higher child-pugh score and d-dimer level were all risk factors for portal vein thrombosis in patients with liver cirrhosis. Results of Pearson correlation analysis showed that the maximum blood flow velocity of portal vein in patients with liver cirrhosis was negatively correlated with the width of portal vein and the thickness of spleen （r=-0.991, P =0.000）. R =-0.977, P=0.O00）; The maximum blood flow velocity of portal vein in patients with liver cirrhosis was negatively correlated with the level of d-dimer （r=-0.986, P =0.000）. The child-pugh score of patients with cirrhosis was positively correlated with their d-dimer level （r=0.979, P=0.000）. Conclusion： the risk factors for portal vein thrombosis in patients with liver cirrhosis mainly include lower maximum flow velocity of portal vein, increased portal vein width and spleen thickness, higher child-pugh score and d-dimer level.