门静脉血栓形成因素预测研究进展

Research Progress of Factors Predicting Portal Vein Thrombosis

门静脉血栓形成(portal vein thrombosis,PVT)是指门静脉主干和肝内门静脉分支内形成的血栓,伴或不伴有肠系膜和脾静脉受累,其特征是门静脉部分或完全闭塞。PVT是肝硬化患者常见而严重的并发症,且发生率与肝硬化和门静脉高压严重程度呈正相关。门静脉血栓形成不仅可以使肝硬化患者肝功能恶化,加重门静脉高压并导致门静脉高压相关的静脉曲张出血,从而增加肝硬化急性失代偿的发生风险,还会增加肝移植手术难度,降低受者生存率。因此,对于PVT的早期预防尤为重要。由于PVT常起病隐匿,早期一般无明显临床症状,根据临床表现很难诊断PVT,因此研究反映潜在血栓形成的血清学指标至关重要。由于Virchow三联征的组成部分,所有静脉血栓形成都是多因素的:高凝状态、内皮损伤和血流量减少。本文就PVT形成的危险因素及早期预测血清学指标的最新研究进行综述。

Portal vein thrombosis(PVT)is a thrombosis in the main portal vein and branches of the portal vein within the liver,with or without mesenteric and splenic vein involvement,characterized by partial or complete occlusion of the portal vein.It is a common and serious complication in patients with cirrhosis,and its incidence is positively correlated with the severity of cirrhosis and portal hypertension.Portal vein thrombosis can worsen liver function in cirrhotic patients,exacerbate portal hypertension and lead to variceal bleeding associated with portal hypertension,which may increase the risk of acute cirrhotic failure,and it can also make liver transplantation more difficult and reduce the survival rate of the recipient,making early detection and prevention of PVT particularly important.However,as PVT often has an insidious onset and there are usually no obvious clinical symptoms in the early stages,it is difficult to diagnose PVT based on the clinical presentation;therefore,it is crucial to study serological indicators reflecting potential thrombosis,as all venous thrombosis is multifactorial due to the components of the Virchow triad:hypercoagulable state,endothelial damage and reduced blood flow.This article provides a review of recent studies on risk factors for PVT formation and serological indicators for early prediction.