Ru Nan, He Chao Hui, Ren Xin Lu, Chen Jia Yun, Yu Fei Fei, Yan Zi Jun, Guo Ji Yao, Zhu Jia Hui, Wang Yuan Chen, Qian Yang Yang, Pan Jun, Hu Liang Hao, Li Zhao Shen, Zou Wen Bin, Liao Zhuan
Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University, Shanghai, China.
Shanghai Institute of Pancreatic Diseases, Shanghai, China.
J Dig Dis. 2020 Aug;21(8):468-474. doi: 10.1111/1751-2980.12916. Epub 2020 Aug 4.
Sinistral portal hypertension (SPH) is an uncommon complication of chronic pancreatitis (CP) and can result in severe gastrointestinal bleeding. The aim of this study was to determine the prevalence and the potential risk factors for SPH and related gastrointestinal variceal bleeding in patients with CP.
We retrospectively reviewed all patients with SPH due to CP admitted to our hospital from July 2014 to June 2019 in this case-control study. Patients with CP without SPH were randomly selected as controls during the study period (case: control = 1:2). The characteristics, medical history, course of CP, characteristics associated with SPH, and follow-up evaluations of the patients were documented in detail. The prevalence rate of SPH in patients with CP and related gastrointestinal bleeding was calculated. Risk factors for SPH and related variceal bleeding were analyzed using univariate or multivariate logistic regression analysis.
The prevalence of SPH was 2.7% (89/3358) in patients with CP. Independent risk factors for SPH included alcohol consumption (P = 0.030), history of acute pancreatitis (P = 0.010), diabetes mellitus (P < 0.001), and pseudocysts (P < 0.001). Overall 17 (19.1%) patients suffered from related gastrointestinal bleeding. Between the bleeding and non-bleeding groups, there were significant differences in the types of CP, existence of stones, gastric varices diagnosed before bleeding, splenomegaly and hypersplenism by univariate analysis.
SPH is a rare complication of CP that is associated with a relatively low risk of variceal bleeding.
左侧门静脉高压（SPH）是慢性胰腺炎（CP）的一种罕见并发症，可导致严重的胃肠道出血。本研究的目的是确定CP患者中SPH及相关胃肠道静脉曲张出血的患病率和潜在危险因素。
在这项病例对照研究中，我们回顾性分析了2014年7月至2019年6月期间我院收治的所有因CP导致SPH的患者。在研究期间，随机选择无SPH的CP患者作为对照（病例：对照 = 1:2）。详细记录患者的特征、病史、CP病程、与SPH相关的特征以及随访评估情况。计算CP患者中SPH及相关胃肠道出血的患病率。采用单因素或多因素逻辑回归分析SPH及相关静脉曲张出血的危险因素。
CP患者中SPH的患病率为2.7%（89/3358）。SPH的独立危险因素包括饮酒（P = 0.030）、急性胰腺炎病史（P = 0.010）、糖尿病（P < 0.001）和假性囊肿（P < 0.001）。共有17例（19.1%）患者发生相关胃肠道出血。单因素分析显示，出血组和未出血组在CP类型、结石存在情况、出血前诊断的胃静脉曲张、脾肿大和脾功能亢进方面存在显著差异。
SPH是CP的一种罕见并发症，静脉曲张出血风险相对较低。
