Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area).
Graduate School, China Medical University, Shenyang, China.
Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e423-e430. doi: 10.1097/MEG.0000000000002123.
Portal venous system thrombosis (PVST) will progress in some cases, indicating worse outcome and the necessity of antithrombotic treatment, but will spontaneously improve in others. It is crucial to understand the natural history of PVST in liver cirrhosis. However, the knowledge regarding how to predict the evolution of PVST in cirrhotic patients is very scant.
Sixty-nine cirrhotic patients without malignancy, who had undergone repeated contrast-enhanced computed tomography or MRI to evaluate the severity of PVST at the first and last admissions, were included. Logistic regression analysis was performed to identify the risk factors for the evolution of PVST in liver cirrhosis. Odds ratios (ORs) were calculated.
Among 42 patients without PVST at the first admission, 10 (23.8%) developed PVST at the last admission. Serum albumin level (OR = 0.873), prothrombin time (OR = 1.619), activated partial thromboplastin time (OR = 1.169), Child-Pugh score (OR = 1.560) and model for end-stage liver disease (MELD) score (OR = 1.292) at the last admission were significant risk factors associated with the development of PVST. Among 27 patients with PVST at the first admission, 11 (40.7%), 4 (14.8%) and 12 (44.4%) had improvement, stabilization and progression of PVST at the last admission, respectively. ΔMELD score (OR = 0.714) was the only significant risk factor associated with the improvement of PVST; additionally, serum albumin level at the first admission (OR = 1.236) was the only significant risk factor associated with the progression of PVST.
Aggravation and amelioration of liver dysfunction may predict the development and improvement of PVST in liver cirrhosis, respectively.
门静脉系统血栓形成（PVST）在某些情况下会进展，表明预后更差，需要进行抗血栓治疗，但在其他情况下会自行改善。了解肝硬化患者中 PVST 的自然史至关重要。然而，关于如何预测肝硬化患者 PVST 演变的知识非常有限。
纳入 69 例无恶性肿瘤的肝硬化患者，这些患者在首次和最后一次入院时均接受了多次增强 CT 或 MRI 检查以评估 PVST 的严重程度。进行逻辑回归分析以确定肝硬化患者中 PVST 演变的危险因素。计算比值比（OR）。
在首次入院时无 PVST 的 42 例患者中，有 10 例（23.8%）在最后一次入院时发生了 PVST。最后一次入院时的血清白蛋白水平（OR=0.873）、凝血酶原时间（OR=1.619）、活化部分凝血活酶时间（OR=1.169）、Child-Pugh 评分（OR=1.560）和终末期肝病模型评分（MELD 评分）（OR=1.292）是与 PVST 发展相关的显著危险因素。在首次入院时患有 PVST 的 27 例患者中，分别有 11 例（40.7%）、4 例（14.8%）和 12 例（44.4%）在最后一次入院时出现了 PVST 的改善、稳定和进展。ΔMELD 评分（OR=0.714）是与 PVST 改善相关的唯一显著危险因素；此外，首次入院时的血清白蛋白水平（OR=1.236）是与 PVST 进展相关的唯一显著危险因素。
肝功能恶化和改善可能分别预测肝硬化中 PVST 的发展和改善。
