1Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
2Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca, Universidad de Salamanca, Salamanca, Spain.
Am J Trop Med Hyg. 2021 Jul 19;105(3):692-697. doi: 10.4269/ajtmh.21-0274.
Cystic echinococcosis (CE) is a parasitic disease caused by the larval forms of species of the tapeworm Echinococcus. The most common location is the liver. To assess the frequency and clinical characteristics of portal hypertension (PH) and the risk factors for PH development, we performed a retrospective observational study of inpatients diagnosed with hepatic CE and PH from January 1998 to December 2018, at Complejo Asistencial Universitario de Salamanca, Spain. Of 362 patients analyzed with hepatic CE, 15 inpatients (4.1%) had a portal vein diameter ≥ 14 mm, and the mean diameter of the portal vein was 16.9 (standard deviation [SD] ±2.1) mm. Twelve patients were men. The mean age was 59.5 years (SD ± 17.8 years). Four patients had ascites (26.6%), four had collateral circulation (26.6%), 14 had hepatosplenomegaly (93.3%), five had esophageal varices (33.3%), four had hematemesis, and three had jaundice. Other causes of PH included hepatitis B virus (1 patient) and hepatitis C virus (1 patient) infections and alcohol abuse (1 patient). The host variables associated with PH development were male sex (odds ratio, 4.6; 95% confidence interval, 1.1-20.9; P = 0.030) and larger cyst size (10.8 ± 6.3 versus 7.6 ± 4.1; P = 0.004). Hepatic CE is an infrequent cause of PH that usually occurs without indications of liver failure. Larger cyst size and male sex were the main risk factors associated with this complication. Mortality was higher for patients with hepatic CE with PH than for patients with hepatic CE without PH.
肝包虫病（CE）是一种由带绦虫属幼虫引起的寄生虫病。最常见的部位是肝脏。为了评估门静脉高压症（PH）的频率和临床特征以及 PH 发展的危险因素，我们对 1998 年 1 月至 2018 年 12 月期间在西班牙萨拉曼卡综合医疗中心诊断为肝包虫病和 PH 的住院患者进行了回顾性观察研究。在分析的 362 例肝包虫病患者中，15 例患者门静脉直径≥14mm，门静脉平均直径为 16.9（标准差[SD]±2.1）mm。12 例为男性。平均年龄为 59.5 岁（SD±17.8 岁）。4 例有腹水（26.6%），4 例有侧支循环（26.6%），14 例有肝脾肿大（93.3%），5 例有食管静脉曲张（33.3%），4 例有呕血，3 例有黄疸。其他引起 PH 的原因包括乙型肝炎病毒（1 例）和丙型肝炎病毒（1 例）感染和酒精滥用（1 例）。与 PH 发展相关的宿主变量是男性（比值比，4.6；95%置信区间，1.1-20.9；P=0.030）和更大的囊肿大小（10.8±6.3 与 7.6±4.1；P=0.004）。肝包虫病是 PH 的一种不常见病因，通常在没有肝功能衰竭迹象的情况下发生。更大的囊肿大小和男性是与这种并发症相关的主要危险因素。与无 PH 的肝包虫病患者相比，有 PH 的肝包虫病患者的死亡率更高。
