乙肝肝硬化门静脉高压患者TIPS前后门静脉、肝静脉血清CXCL9水平变化及其意义

发布时间：2018-07-07 18:39

  本文选题：肝硬化 + 乙型病毒性肝炎　； 参考：《山东医药》2017年08期

【摘要】：目的探讨乙肝肝硬化门静脉高压患者经颈静脉肝内门体分流术(TIPS)前后门静脉、肝静脉血清CXCL9水平变化及其与患者预后的关系。方法选择行TIPS的乙肝肝硬化门静脉高压患者80例,术后中位生存时间为293天,其中≥293天者37例,293天者43例。分析80例患者术前及术后14天相关实验室检查资料,如CXCL9、胆红素、胆碱酯酶、白蛋白、ALT、AST、γ-谷氨酰转肽酶、国际标准化比率、血肌酐、尿素氮、血清钠、PLT、门静脉压力、中心静脉压力、门静脉血流速度,比较生存时间≥293天者与293天者上述指标变化,并筛选影响患者预后的危险因素。结果 80例患者术后门静脉和肝静脉血清CXCL9水平均低于术前(P均0.05)。单因素分析发现,生存时间≥293天者与293天者术前门静脉和肝静脉血清CXCL9、Na+、血肌酐、尿素氮、胆红素水平以及术后门静脉压比较P均0.05;其他相关实验室检查资料比较P均0.05。多因素Cox回归分析发现,术前门静脉血清CXCL9水平是患者预后的独立影响因素(OR=0.261,95%CI为0.132~0.524,P0.01)。术前门静脉血清CXCL9≥400 pg/m L者与400 pg/m L者平均生存时间分别为113、941天,二者比较P0.01。结论乙肝肝硬化门静脉高压患者TIPS术后门静脉、肝静脉血清CXCL9水平明显降低;术前门静脉血清CXCL9水平≥400 pg/m L者预后较差。
[Abstract]:Objective to investigate the changes of serum CXCL9 levels in portal vein and hepatic vein before and after tranjugular intrahepatic portosystemic shunt (tips) in patients with hepatitis B cirrhosis and its relationship with prognosis. Methods 80 patients with portal hypertension due to hepatitis B cirrhosis were treated with tips. The median survival time was 293 days, of which 37 cases were more than 293 days and 43 patients were at least 293 days. The laboratory data of 80 patients before and 14 days after operation were analyzed, such as CXCL9, bilirubin, cholinesterase, ALTAST, 纬 -glutamyl transpeptidase, international standardized ratio, serum creatinine, urea nitrogen, serum natriuretic acid, portal vein pressure. The central venous pressure, portal vein blood flow velocity, survival time 鈮，

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