Department of Infectious Disease, the First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Interventional Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.
Clin Mol Hepatol. 2019 Jun;25(2):210-217. doi: 10.3350/cmh.2018.0083. Epub 2019 Mar 22.
BACKGROUND/AIMS: In recent years, greater assessment accuracy after transjugular intrahepatic portosystemic shunt (TIPS) to ascertain prognosis has become important in decompensated cirrhosis due to portal hypertension. The aim of this study was to assess the ratio of the portal pressure gradient (PPG) pre-TIPS (pre-PPG) to albumin (PPA), which influence ascites formation in cirrhotic patients in the 6-months after TIPS placement, and is a metric introduced in our study.
This was a retrospective cohort study of 58 patients with decompensated cirrhosis admitted to an academic hospital for the purpose of TIPS placement. We collected the following data: demographics, laboratory measures, and PPG during the TIPS procedure. Then we analyzed the association between the above data and ascites formation postTIPS in cirrhosis patients.
Twenty-two patients with ascites and 28 without ascites were evaluated. Univariate and binary logistic regression analysis were adjusted for the following variables: to determine prognosis; Child-Pugh scores, lymphocyte count, platelet count, hemoglobin level, albumin level and pre-PPG or PPA. The outcome showed that PPA was better than pre-PPG and albumin for predicting ascites according to area under receiver operating characteristic curves and a statistical model that also showed PPA's influence 6-months post-TIPS.
The combined measurement of pre-PPG and albumin, defined as PPA, may provide a better way to predict post-TIPS ascites in decompensated cirrhosis, which underlines the need for a large clinical trial in the future.
背景/目的：近年来，由于门静脉高压导致的代偿期肝硬化，在经颈静脉肝内门体分流术（TIPS）后进行更准确的评估以确定预后变得尤为重要。本研究的目的是评估 TIPS 前（pre-PPG）门静脉压力梯度（PPG）与白蛋白（PPA）的比值，该比值影响 TIPS 放置后 6 个月内肝硬化患者腹水的形成，这是我们研究中引入的一个指标。
这是一项回顾性队列研究，纳入了 58 例因 TIPS 植入术而入住学术医院的失代偿期肝硬化患者。我们收集了以下数据：人口统计学资料、实验室指标和 TIPS 过程中的 PPG。然后，我们分析了上述数据与肝硬化患者 TIPS 后腹水形成之间的关系。
我们评估了 22 例有腹水和 28 例无腹水的患者。单变量和二元逻辑回归分析调整了以下变量：以确定预后；Child-Pugh 评分、淋巴细胞计数、血小板计数、血红蛋白水平、白蛋白水平和 pre-PPG 或 PPA。结果显示，根据受试者工作特征曲线下面积和统计模型，PPA 比 pre-PPG 和白蛋白更能预测腹水，该模型还显示 PPA 在 TIPS 后 6 个月的影响。
pre-PPG 和白蛋白的联合测量，定义为 PPA，可能为预测失代偿期肝硬化 TIPS 后腹水提供一种更好的方法，这突显了未来进行大型临床试验的必要性。
