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非恶性和非肝硬化门静脉海绵样变性患者的预后因素:一项 8 年回顾性单中心研究。

Prognostic factors in non-malignant and non-cirrhotic patients with portal cavernoma: an 8-year retrospective single-center study.

机构信息

Xing-Shun Qi, Ming Bai, Chuang-Ye He, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Fei-Fei Wu, Guo-Hong Han, Department of Liver Diseases and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.

出版信息

World J Gastroenterol. 2013 Nov 14;19(42):7447-54. doi: 10.3748/wjg.v19.i42.7447.

Abstract

AIM

To evaluate the outcome of non-malignant and non-cirrhotic patients with portal cavernoma and to determine the predictors for survival.

METHODS

Between July 2002 and June 2010, we retrospectively enrolled all consecutive patients admitted to our department with a diagnosis of portal cavernoma without abdominal malignancy or liver cirrhosis. The primary endpoint of this observational study was death and cause of death. Independent predictors of survival were identified using the Cox regression model.

RESULTS

A total of 64 patients were enrolled in the study. During a mean follow-up period of 18 ± 2.41 mo, 7 patients died. Causes of death were pulmonary embolism (n = 1), acute leukemia (n = 1), massive esophageal variceal hemorrhage (n = 1), progressive liver failure (n = 2), severe systemic infection secondary to multiple liver abscesses (n = 1) and accident (n = 1). The cumulative 6-, 12- and 36-mo survival rates were 94.9%, 86% and 86%, respectively. Multivariate Cox regression analysis demonstrated that the presence of ascites (HR = 10.729, 95%CI: 1.209-95.183, P = 0.033) and elevated white blood cell count (HR = 1.072, 95%CI: 1.014-1.133, P = 0.015) were independent prognostic factors of non-malignant and non-cirrhotic patients with portal cavernoma. The cumulative 6-, 12- and 36-mo survival rates were significantly different between patients with and without ascites (90%, 61.5% and 61.5% vs 97.3%, 97.3% and 97.3%, respectively, P = 0.0008).

CONCLUSION

The presence of ascites and elevated white blood cell count were significantly associated with poor prognosis in non-malignant and non-cirrhotic patients with portal cavernoma.

摘要

目的

评估非恶性和非肝硬化门静脉海绵样变性患者的结局,并确定生存的预测因素。

方法

2002 年 7 月至 2010 年 6 月,我们回顾性地招募了所有因非恶性腹部肿瘤或肝硬化而被诊断为门静脉海绵样变性的连续入院患者。本观察性研究的主要终点是死亡和死亡原因。使用 Cox 回归模型确定生存的独立预测因素。

结果

共纳入 64 例患者。在平均 18±2.41 个月的随访期间,7 例患者死亡。死亡原因分别为肺栓塞(n=1)、急性白血病(n=1)、大量食管静脉曲张出血(n=1)、进行性肝功能衰竭(n=2)、多发肝脓肿继发严重全身感染(n=1)和意外(n=1)。6、12 和 36 个月的累积生存率分别为 94.9%、86%和 86%。多变量 Cox 回归分析表明,腹水的存在(HR=10.729,95%CI:1.209-95.183,P=0.033)和白细胞计数升高(HR=1.072,95%CI:1.014-1.133,P=0.015)是非恶性和非肝硬化门静脉海绵样变性患者的独立预后因素。有腹水和无腹水患者的 6、12 和 36 个月累积生存率差异有统计学意义(90%、61.5%和 61.5%与 97.3%、97.3%和 97.3%,P=0.0008)。

结论

腹水和白细胞计数升高与非恶性和非肝硬化门静脉海绵样变性患者的不良预后显著相关。

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