非肝硬化非恶性肝外门静脉血栓形成患者的腹水。
Ascites in patients with noncirrhotic nonmalignant extrahepatic portal vein thrombosis.
机构信息
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
出版信息
Aliment Pharmacol Ther. 2010 Aug;32(4):529-34. doi: 10.1111/j.1365-2036.2010.04375.x. Epub 2010 May 22.
AIMS
To assess the frequency, natural history and prognostic implication of ascites in patients with EPVT and to identify risk factors for this complication.
METHODS
A single-centre retrospective study of consecutive patients diagnosed with noncirrhotic nonmalignant EPVT between 1985 and 2009.
RESULTS
One hundred and three patients [35% males; median age 43 (range 16-83) years] were included and followed up for a median time of 5.2 (range 0.9-32.5) years. Twenty-nine (28%) had ascites at the time of diagnosis. Overall survival was 91% at 5 years vs. 80% at 10 years. Survival in patients presenting with and without ascites was 83% vs. 95% at 5 years and 42% vs. 87% at 10 years (P = or < 0.01). There was no correlation between the presence of ascites and extension of the thrombus into the large splanchnic veins, duration of thrombosis or presence of gastrointestinal bleeding.
CONCLUSIONS
Ascites is present in a quarter of patients presenting with noncirrhotic nonmalignant extrahepatic portal vein thrombosis. Ascites is a significant and independent prognostic factor and it is associated with a decreased long-term survival.
目的
评估 EPVT 患者中腹水的频率、自然史和预后意义，并确定这种并发症的危险因素。
方法
对 1985 年至 2009 年间连续诊断为非肝硬化非恶性 EPVT 的患者进行单中心回顾性研究。
结果
共纳入 103 例患者[35%为男性；中位年龄 43（16-83）岁]，中位随访时间为 5.2（0.9-32.5）年。29 例（28%）在诊断时存在腹水。5 年总生存率为 91%，10 年总生存率为 80%。有腹水和无腹水患者的 5 年生存率分别为 83%和 95%，10 年生存率分别为 42%和 87%（P=或<0.01）。腹水的存在与血栓延伸至大的内脏静脉、血栓形成的持续时间或胃肠道出血之间无相关性。
结论
在非肝硬化非恶性肝外门静脉血栓形成患者中，有四分之一的患者存在腹水。腹水是一个显著的独立预后因素，与长期生存率降低有关。
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