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伊朗设拉子等待肝移植的肝硬化患者门静脉血栓形成的危险因素

Risk Factors for Portal Vein Thrombosis in Patients With Cirrhosis Awaiting Liver Transplantation in Shiraz, Iran.

作者信息

Bagheri Lankarani Kamran, Homayon Katayon, Motevalli Dorna, Heidari Seyed Taghi, Alavian Seyed Moayed, Malek-Hosseini Seyed Ali

机构信息

Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.

Gastroenterology and Hepatology Rearch Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.

出版信息

Hepat Mon. 2015 Dec 27;15(12):e26407. doi: 10.5812/hepatmon.26407. eCollection 2015 Dec.

Abstract

BACKGROUND

Portal vein thrombosis is a fairly common and potentially life-threatening complication in patients with liver cirrhosis. The risk factors for portal vein thrombosis in these patients are still not fully understood.

OBJECTIVES

This study aimed to investigate the associations between various risk factors in cirrhotic patients and the development of portal vein thrombosis.

PATIENTS AND METHODS

In this case-control study performed at the Shiraz organ transplantation center, Iran, we studied 219 patients (> 18 years old) with liver cirrhosis, who were awaiting liver transplants in our unit, from November 2010 to May 2011. The patients were evaluated by history, physical examination, and laboratory tests, including factor V Leiden, prothrombin gene mutation, Janus Kinase 2 (JAK2) mutation, and serum levels of protein C, protein S, antithrombin III, homocysteine, factor VIII, and anticardiolipin antibodies.

RESULTS

There was no statistically significant difference in the assessed hypercoagulable states between patients with or without portal vein thrombosis. A history of previous variceal bleeding with subsequent endoscopic treatment in patients with portal vein thrombosis was significantly higher than in those without it (P = 0.013, OR: 2.526, 95% CI: 1.200 - 5.317).

CONCLUSIONS

In our population of cirrhotic patients, treatment of variceal bleeding predisposed the patients to portal vein thrombosis, but hypercoagulable disorders by themselves were not associated with portal vein thrombosis.

摘要

背景

门静脉血栓形成是肝硬化患者中一种相当常见且可能危及生命的并发症。这些患者门静脉血栓形成的危险因素仍未完全明确。

目的

本研究旨在探讨肝硬化患者各种危险因素与门静脉血栓形成之间的关联。

患者与方法

在伊朗设拉子器官移植中心进行的这项病例对照研究中,我们研究了2010年11月至2011年5月在我们科室等待肝移植的219例(年龄>18岁)肝硬化患者。通过病史、体格检查和实验室检查对患者进行评估,包括凝血因子V莱顿突变、凝血酶原基因突变、Janus激酶2(JAK2)突变以及蛋白C、蛋白S、抗凝血酶III、同型半胱氨酸、凝血因子VIII和抗心磷脂抗体的血清水平。

结果

有或无门静脉血栓形成的患者在评估的高凝状态方面无统计学显著差异。门静脉血栓形成患者既往有静脉曲张出血并随后接受内镜治疗的病史显著高于无此情况的患者(P = 0.013,OR:2.526,95%CI:1.200 - 5.317)。

结论

在我们的肝硬化患者群体中,静脉曲张出血的治疗使患者易患门静脉血栓形成,但高凝性疾病本身与门静脉血栓形成无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87d9/4779252/631917dd5714/hepatmon-15-12-26407-i001.jpg

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