肝硬化门静脉血栓形成危险因素分析

Risk factors of portal vein thrombosis in cirrhosis

目的:研究肝硬化患者门静脉血栓形成(PVT)的相关危险因素。方法:本研究前瞻性共纳入肝硬化患者149例,其中50例合并PVT为肝硬化PVT组,另有99例为肝硬化无PVT组。记录临床资料包括肝硬化病因和Child-Pugh分级;除常规实验室检查外,还监测凝血四项、D-二聚体、抗凝血酶-Ⅲ(ATⅢ)和蛋白C(PC)等。采用非条件Logistic回归分析筛选出相关危险因素。结果:单因素检验显示肝硬化PVT组的血液D-二聚体和血小板(PLT)水平明显高于无PVT组(P<0.05),而两组AT-Ⅲ、PC血清水平相近,差异无统计学意义(P>0.05)。非条件Logistic回归分析结果显示D-二聚体与肝硬化PVT呈正相关(P<0.001,OR=1.275);而PLT与PVT相关性并无统计学意义(P>0.05)。结论:高血D-二聚体是肝硬化PVT的相关危险因素。

Objective: To investigate the risk factors for portal vein thrombosis( PVT) in cirrhotic patients.Methods: A total of 149 cirrhotic patients were prospectively enrolled in this study. Among them,50 patients with PVT were assigned to the PVT group and 99 without PVT to the non-PVT group. The clinical data were recorded including the cause of cirrhosis and Child-Pugh classification. In addition to routine laboratory tests,the four-item coagulation functions,D-dimer,antithrombin-III( AT-III) and protein C( PC) levels were determined. Nonconditional Logistic regression analysis was used to screen for the potential risk factors. Results: Univariate analysis showed that the levels of blood D-dimer and platelet( PLT) in the PVT group were significantly higher than those in the non-PVT group( P<0.05),but the serum levels of AT-III and PC in the two groups were similar without statistical difference( P > 0. 05). Non-conditional Logistic regression analysis showed that D-dimer was positively correlated with PVT in cirrhosis( P<0.001,OR = 1.275). There was no significant correlation between PLT and PVT( P>0.05). Conclusion: High blood level of D-dimer is a risk factor for PVT in cirrhosis.