Ghazaleh Sami, Beran Azizullah, Aburayyan Kanana, Nehme Christian, Patel Dipen, Khader Yasmin, Sharma Sachit, Aziz Muhammad, Abdel-Aziz Yousef, Hammad Tariq, Nawras Ali
Department of Internal Medicine, University of Toledo, Toledo, OH (Sami Ghazaleh, Azizullah Beran, Kanana Aburayyan, Christian Nehme, Dipen Patel, Yasmin Khader, Sachit Sharma, Muhammad Aziz).
Department of Gastroenterology and Hepatology, University of Tennessee, Memphis, TN (Yousef Abdel-Aziz).
Ann Gastroenterol. 2021;34(1):104-110. doi: 10.20524/aog.2020.0544. Epub 2020 Oct 2.
The role of anticoagulation in treating non-malignant portal vein (PV) thrombosis (PVT) in patients with liver cirrhosis remains unclear. In our meta-analysis, we aimed to evaluate the efficacy and safety of anticoagulation for the treatment of non-malignant PVT in these patients.
We conducted a meta-analysis to estimate the effects of anticoagulation on non-malignant PVT in patients with liver cirrhosis. We assessed the rates of PV recanalization, variceal bleeding, and any bleeding.
We included 9 observational studies which involved 474 patients. The rate of PV recanalization was significantly higher in patients who received anticoagulation compared to those who did not: 65.2% vs. 25.2%; relative risk (RR) 2.31, 95% confidence interval (CI) 1.80-2.96; P<0.00001. Variceal bleeding was significantly lower in patients who received anticoagulation: 0.1% vs. 18.5%; RR 0.15, 95%CI 0.04-0.55; P=0.004. Any bleeding was similar between patients who received anticoagulation and those who did not: 10.3% vs. 22.7%; RR 0.43, 95%CI 0.09-1.99; P=0.28.
Anticoagulation use increased the rate of PV recanalization in cirrhotic patients with non-malignant PVT. Anticoagulation decreased the rate of variceal bleeding and did not increase the rate of any bleeding.
抗凝治疗在肝硬化患者非恶性门静脉（PV）血栓形成（PVT）中的作用尚不清楚。在我们的荟萃分析中，旨在评估抗凝治疗这些患者非恶性PVT的疗效和安全性。
我们进行了一项荟萃分析，以评估抗凝治疗对肝硬化患者非恶性PVT的影响。我们评估了PV再通率、静脉曲张出血率和任何出血情况。
我们纳入了9项观察性研究，涉及474例患者。接受抗凝治疗的患者PV再通率显著高于未接受抗凝治疗的患者：65.2%对25.2%；相对危险度（RR）2.31，95%置信区间（CI）1.80 - 2.96；P<0.00001。接受抗凝治疗的患者静脉曲张出血率显著降低：0.1%对18.5%；RR 0.15，95%CI 0.04 - 0.55；P = 0.004。接受抗凝治疗和未接受抗凝治疗的患者任何出血情况相似：10.3%对22.7%；RR 0.43，95%CI 0.09 - 1.99；P = 0.28。
抗凝治疗可提高肝硬化非恶性PVT患者的PV再通率。抗凝治疗可降低静脉曲张出血率，且不会增加任何出血率。
