乙型肝炎肝硬化患者门静脉血栓发生的影响因素及抗凝治疗效果研究

Study on the Influencing Factors of Portal Vein Thrombosis and the Effect of Anticoagulant Therapy in Patients with Hepatitis B Cirrhosis

目的:探讨乙型肝炎肝硬化(HBC)患者门静脉血栓(PVT)发生的影响因素及抗凝治疗效果。方法:回顾性分析2018年6月至2019年6月于河南科技大学第一附属医院接受治疗且完成随访的HBC患者的临床资料,从中筛选出符合条件的86例患者作为研究对象,根据是否发生PVT分为发生PVT组和未发生PVT组,分析HBC患者PVT发生的影响因素及抗凝治疗的效果。结果:86例HBC患者中,有17例发生PVT,占比19.77%;17例PVT患者均行抗凝治疗,其中6例血栓部位完全再通,占35.29%,8例血栓部位部分再通,占47.06%,3例治疗无效,占17.65%;单因素分析结果显示,两组脾脏切除史、血小板(PLT)计数、上消化道出血史比较,差异具有统计学意义(P<0.05);多因素logistic回归分析检验结果显示,脾脏切除史、上消化道出血史、PLT计数较高是HBC患者PVT发生的危险因素(P<0.05)。结论:脾脏切除史、上消化道出血史、PLT计数较高是HBC患者PVT发生的影响因素,抗凝治疗可能有助于促进并发PVT患者血栓溶解,促进血管再通。

Objective To investigate the influencing factors of portal vein thrombosis(PVT)in patients with hepatitis B Cirrhosis(HBC)and the effect of anticoagulant therapy.Methods 86 patients with HBC who were treated in the First Affiliated Hospital of Henan University of Science and technology from June 2018 to June 2019 were retrospectively analyzed,the PVT group was divided into PVT group and non-PVT group,and the influencing factors of PVT and the effect of anticoagulant therapy were analyzed.Results Among 86 HBC patients,17(19.77%)had PVT,17(35.29%)had anticoagulant therapy,6(35.29%)had complete recanalization,8(47.06%)had partial recanalization,3(17.65%)had no response The results of univariate analysis showed that there were significant differences in the history of SPLENECTOMY,Plt count and Upper gastrointestinal bleeding between the two groups(P<0.05),the history of SPLENECTOMY,Upper gastrointestinal bleeding history and PLT count were the risk factors of PVT in HBC patients(P<0.05).Conclusion The history of SPLENECTOMY,Upper gastrointestinal bleeding history and high PLT count are the influencing factors of PVT in HBC patients.anticoagulant therapy may be helpful to promote thrombolysis and vascular recanalization in PVT patients.