591例肝硬化患者门静脉血栓形成的危险因素分析

发布时间：2019-04-25 20:02

【摘要】：目的研究内镜治疗预防肝硬化食管胃静脉曲张再出血患者门静脉血栓(portal vein thrombosis,PVT)形成的相关危险因素。方法回顾性分析2008-2013年间就诊于复旦大学附属中山医院消化科行内镜治疗预防食管胃静脉曲张再出血的肝硬化患者,收集相关临床资料,对可能影响PVT形成的因素进行单因素分析和多因素Logistic回归分析。结果研究共纳入患者591名,分为PVT组(n=122,20.64%)和无PVT组(n=469,79.36%)。单因素分析显示两组间MELD评分、血红蛋白、血小板计数、总胆红素、丙氨酸氨基转移酶、血尿素氮、切脾比例差异存在统计学意义(P0.05)。多因素Logistic回归发现:MELD评分、血尿素氮降低、D-二聚体升高、脾脏切除史是与PVT形成相关的独立危险因素(P值分别为0.016,0.026,0.014和0.001)。结论肝硬化患者应定期随访MELD评分、肝功能、D-二聚体水平及腹部超声,对有脾脏切除史的患者需给予更高警惕。
[Abstract]:Objective to study the risk factors for the prevention of portal vein thrombosis (portal vein thrombosis,PVT) in cirrhotic patients with esophageal and gastric varices rebleeding by endoscopic therapy. Methods retrospective analysis was made on patients with liver cirrhosis who were treated with endoscopy in the Department of Gastroenterology, Zhongshan Hospital affiliated to Fudan University from 2008 to 2013. The clinical data were collected. The factors that may affect the formation of PVT were analyzed by single factor analysis and multi-factor Logistic regression analysis. Results A total of 591 patients were divided into PVT group (n = 122, 20.64%) and non-PVT group (n = 469, 79.36%). Univariate analysis showed that there were significant differences in MELD score, hemoglobin, platelet count, total bilirubin, alanine aminotransferase, blood urea nitrogen and splenectomy ratio between the two groups (P0.05). Multivariate Logistic regression showed that MELD score, decreased blood urea nitrogen, increased D-dimer and history of splenectomy were independent risk factors associated with PVT formation (P = 0.016,0.026,0.014 and 0.001, respectively). Conclusion patients with liver cirrhosis should be followed up regularly on MELD score, liver function, D-dimer level and abdominal ultrasound, and should be more vigilant in patients with history of splenectomy.
【作者单位】：复旦大学附属中山医院消化科-复旦大学循证医学中心;
【基金】：上海市科学技术委员会科研计划项目(15411950501)~~
【分类号】：R575.2

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