Division of Gastroenterology and Hepatology, Mayo Clinic, E Mayo Blvd. 5777, Phoenix, AZ 85054, USA.
Dig Dis Sci. 2013 Jun;58(6):1776-80. doi: 10.1007/s10620-012-2548-y. Epub 2013 Jan 12.
The prevalence of portal vein thrombosis (PVT) increases with the severity of liver disease. Development of PVT is often accompanied by increased rate of morbidity and mortality and may affect patient candidacy for liver transplant. There is limited data regarding the role of anticoagulation therapy in patients with PVT and liver cirrhosis.
The aims of this study were to describe the prevalence of hypercoagulable disorders in patients with liver cirrhosis and PVT, and to describe the outcome of anticoagulation in patients with liver cirrhosis and PVT.
A retrospective chart review was conducted of patients with liver cirrhosis awaiting liver transplant who were diagnosed with PVT between January 2005 and November 2011.
During the study period, 537 patients were evaluated for liver transplant. Sixty-nine (13 %) patients were diagnosed with portal vein thrombosis. Chronic hepatitis C was the cause of liver disease in 24/69 (35 %) patients, and hepatocellular carcinoma was present in 39 % of patients. In 22 patients screened for hypercoagulable disorders, hypercoagulable disorder was diagnosed in one patient (5 %). Twenty-eight (28/69) patients were treated during the study period with warfarin: PVT resolved in 11/28 (39 %), no change in 5/28 (18 %), and 12/28 (43 %) patients showed partial resolution of thrombus. Eight patients received liver transplant while on anticoagulation, and operative notes confirmed patency of PV in all eight patients.
PVT is frequently seen in patients with end stage liver disease with prevalence of 13 %. Hypercoagulable disorder was detected in 5 % of the patients screened. Careful use of anticoagulation is safe and effective in patients with PVT.
门静脉血栓形成（PVT）的患病率随着肝病的严重程度而增加。PVT 的发展常伴有发病率和死亡率的增加，并可能影响患者进行肝移植的资格。关于抗凝治疗在伴有 PVT 和肝硬化的患者中的作用，数据有限。
本研究的目的是描述肝硬化伴 PVT 患者中高凝状态的发生率，并描述肝硬化伴 PVT 患者抗凝治疗的结果。
对 2005 年 1 月至 2011 年 11 月期间诊断为 PVT 的等待肝移植的肝硬化患者进行了回顾性病历审查。
在研究期间，对 537 例患者进行了肝移植评估。69 例（13%）患者被诊断为门静脉血栓形成。24/69（35%）患者的肝病病因是慢性丙型肝炎，39%的患者存在肝细胞癌。在 22 例筛查高凝状态的患者中，1 例（5%）诊断为高凝状态。28 例（28/69）患者在研究期间接受了华法林治疗：28 例中的 11 例（39%）PVT 得到缓解，5 例（18%）无变化，12 例（43%）患者血栓部分缓解。8 例患者在抗凝治疗期间接受了肝移植，手术记录证实所有 8 例患者的 PV 通畅。
终末期肝病患者中 PVT 很常见，患病率为 13%。在筛查的患者中，有 5%发现高凝状态。在伴有 PVT 的患者中，谨慎使用抗凝剂是安全有效的。
