Endo Kei, Oikawa Takayoshi, Kakisaka Keisuke, Tamura Akio, Ehara Shigeru, Takikawa Yasuhiro
a Division of Hepatology, Department of Internal Medicine , Iwate Medical University School of Medicine , Morioka , Japan.
b Department of Radiology , Iwate Medical University School of Medicine , Morioka , Japan.
Scand J Gastroenterol. 2018 Oct-Nov;53(10-11):1340-1346. doi: 10.1080/00365521.2018.1503327. Epub 2018 Sep 26.
The clinical impact of portal vein thrombosis (PVT) in cirrhotic patients remains unclear. The aim of the study is whether recanalization of acute PVT in nonmalignant cirrhotic patients is associated with their prognosis.
We identified subject with PVT in cirrhotic patients from institutional database. Patients with ≥50% reduction in thrombus size were classified into the improved group and those with ≤49% reduction in thrombus size, or thrombus development in other branches were classified into the deteriorated group. We compared the cumulative survival rate, event-free survival rate (EFS), and liver function (albumin-to-bilirubin (ALBI) and model for end-stage liver disease XI (MELD-XI) between the two groups.
Twenty-seven patients were enrolled in this retrospective study. Sixteen patients were classified into the improved group, and 11 were classified into the deteriorated group. In the improved group, the ALBI grade and MELD-XI measured before the onset of PVT and at one year after the onset of PVT were not significantly different. In contrast, MELD-XI was significantly aggravated in deteriorated group (MELD-XI [p = .02]). The cumulative survival of the two groups did not differ significantly; however, the EFS of the deteriorated group was significantly lower (p = .049).
Residual thrombosis of PVT in cirrhotic patients increased the incidence of liver-related events and was associated with the deterioration of the liver function.
门静脉血栓形成（PVT）对肝硬化患者的临床影响尚不清楚。本研究旨在探讨非恶性肝硬化患者急性PVT再通与其预后是否相关。
我们从机构数据库中识别出肝硬化合并PVT的患者。血栓大小缩小≥50%的患者被归类为改善组，血栓大小缩小≤49%或其他分支出现血栓形成的患者被归类为恶化组。我们比较了两组患者的累积生存率、无事件生存率（EFS）和肝功能（白蛋白与胆红素比值（ALBI）和终末期肝病模型XI（MELD-XI））。
本回顾性研究共纳入27例患者。16例患者被归类为改善组，11例被归类为恶化组。在改善组中，PVT发作前和发作后1年测量的ALBI分级和MELD-XI无显著差异。相比之下，恶化组的MELD-XI显著加重（MELD-XI [p = 0.02]）。两组的累积生存率无显著差异；然而，恶化组的EFS显著较低（p = 0.049）。
肝硬化患者PVT残留血栓增加了肝脏相关事件的发生率，并与肝功能恶化相关。
