Budd-Chiari综合征并发门静脉血栓形成的危险因素分析

发布时间：2018-04-13 18:56

本文选题：Budd-Chiari综合征 + 门静脉　；参考：《中国普通外科杂志》2017年03期

【摘要】：目的:探讨Budd-Chiari综合征(BCS)并发门静脉血栓形成(PVT)的相关危险因素。方法:回顾性分析郑州大学第一附属医院2010年1月—2015年12月确诊的28例BCS并发PVT患者(PVT组)与随机选取同期确诊的40例BCS未并发PVT的患者(非PVT组)的临床资料。采用单因素分析及二分类多因素非条件Logistic回归模型筛选出BCS并发PVT的独立危险因素,用受试者工作特性曲线(ROC)与曲线下面积(AUC)分析各危险因素的诊断效能,并计算最佳临界点。结果:单因素分析显示,PVT组患者在门静脉血流速度、血红蛋白明显低于非PVT组,D-二聚体(DD)、脾脏厚度水平明显高于非PVT组(均P0.05);非条件Logistic回归模型分析显示血浆DD、门静脉血流速度、脾脏厚度是BCS并发PVT的独立危险因素(OR=31.67、0.61、1.23,均P0.05)。ROC曲线显示,门静脉血流速度对BCS并发PVT无诊断价值(AUC0.5),而DD、脾脏厚度的AUC分别为0.724、0.673,诊断BCS并发PVT的最佳临界点分别为0.283μg/L、49.5mm。结论:血浆DD水平、门静脉血流速度、脾脏厚度是BCS并发PVT的独立危险因素,尤其是DD0.283μg/L、脾脏厚度49.5mm的BCS患者,PVT发生的可能性增大。
[Abstract]:Objective: to investigate the risk factors associated with portal vein thrombosis (PVT) in patients with Budd-Chiari syndrome.Methods: the clinical data of 28 patients with BCS complicated with PVT diagnosed in the first affiliated Hospital of Zhengzhou University from January 2010 to December 2015 were retrospectively analyzed and 40 cases of BCS without PVT (non- group) were randomly selected.The independent risk factors of BCS complicated with PVT were screened by univariate analysis and two-class multivariate non-conditional Logistic regression model. The diagnostic effectiveness of each risk factor was analyzed by using the operating characteristic curve (OC) and area under the curve (AUC), and the optimal critical point was calculated.Results: univariate analysis showed that the blood flow velocity of portal vein in PVT group was higher than that in PVT group.Hemoglobin was significantly lower than that in non- group, and the thickness of spleen was significantly higher than that in non- group (all P 0.05), and the blood flow velocities of plasma and portal vein were found by non-conditional Logistic regression analysis.The thickness of spleen was an independent risk factor for BCS complicated with PVT. The mean P0.05).ROC curve showed that portal vein velocity had no diagnostic value for BCS complicated with PVT, but AUC for DDD and spleen thickness were 0.724 ~ 0.673, respectively. The best critical point for the diagnosis of BCS complicated with PVT was 0.283 渭 g / L 49.5 mm.Conclusion: plasma DD level, portal vein blood flow velocity and spleen thickness are independent risk factors for BCS complicated with PVT, especially DD0.283 渭 g / L, BCS with spleen thickness 49.5mm is more likely to occur.
【作者单位】：郑州大学第一附属医院肝胆胰腺外科;
【基金】：河南省科技厅科技计划基金资助项目(132102310424) 河南省卫生和计划生育委员会科研基金资助项目(201403032)
【分类号】：R575

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