Department of Gastroenterology, Tianjin Third Central Hospital, Tianjin 300170, China.
Department of Gastroenterology, Tianjin Third Central Hospital, Tianjin 300170, China.
Clin Res Hepatol Gastroenterol. 2021 Mar;45(2):101649. doi: 10.1016/j.clinre.2021.101649. Epub 2021 Feb 16.
To investigate the efficacy and safety of anticoagulants in liver cirrhosis patients with portal vein thrombosis (PVT).
PubMed, BioMed Central, Cochrane Library and Web of Science were retrieved to identify relevant literature. Forest plots were applied to display the results of the meta-analysis. The odds ratios (ORs) were used as the effect index for the enumeration data, and the effect size was expressed as 95% confidence intervals (CIs). Publication bias was evaluated by funnel plots and Egger's test.
Eight articles included 225 patients with liver cirrhosis and PVT receiving anticoagulants and 232 not receiving anticoagulants. The data demonstrated that the recanalization rate of PVT was significantly higher in patients with anticoagulant treatment than in patients without anticoagulant treatment (OR=5.60; 95% CI: 3.40-9.22; P<0.001). The exacerbation risk of PVT was significantly lower in patients with anticoagulant treatment than in patients without anticoagulant treatment (OR=0.15; 95% CI: 0.04-0.54; P<0.001). A significantly lower portal hypertension bleeding effect was observed in patients with anticoagulant treatment than in patients without anticoagulant treatment (OR=0.21; 95% CI: 0.10-0.45; P<0.001). Low molecular weight heparins (LMWH) were more effective in preventing the PVT exacerbation in liver cirrhosis patients with PVT than warfarin (OR=0.16; 95% CI: 0.08-0.35).
Anticoagulants were effective and safe in treating patients with liver cirrhosis and PVT as they could increase the PVT recanalization rate and decrease the risks of PVT exacerbation and portal hypertension bleeding.
探讨抗凝剂治疗肝硬化合并门静脉血栓形成（PVT）患者的疗效和安全性。
检索PubMed、BioMed Central、Cochrane Library 和 Web of Science 以确定相关文献。采用森林图展示荟萃分析结果。计数资料的效应指标采用比值比（OR），效应大小表示为 95%置信区间（CI）。采用漏斗图和 Egger 检验评估发表偏倚。
纳入 8 篇文献，共包含 225 例接受抗凝剂治疗的肝硬化合并 PVT 患者和 232 例未接受抗凝剂治疗的患者。结果显示，抗凝治疗组 PVT 再通率明显高于未抗凝治疗组（OR=5.60；95%CI：3.40-9.22；P<0.001）。抗凝治疗组 PVT 加重风险明显低于未抗凝治疗组（OR=0.15；95%CI：0.04-0.54；P<0.001）。抗凝治疗组门静脉高压出血效果明显低于未抗凝治疗组（OR=0.21；95%CI：0.10-0.45；P<0.001）。与华法林相比，低分子肝素（LMWH）更能有效预防肝硬化合并 PVT 患者的 PVT 加重（OR=0.16；95%CI：0.08-0.35）。
抗凝剂治疗肝硬化合并 PVT 患者有效且安全，可提高 PVT 再通率，降低 PVT 加重和门静脉高压出血风险。
