Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, PR China; Postgraduate College, Shenyang Pharmaceutical University, Shenyang 110016, PR China.
Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, PR China; Postgraduate College, China Medical University, Shenyang 110122, PR China.
Eur J Intern Med. 2022 Oct;104:21-32. doi: 10.1016/j.ejim.2022.05.032. Epub 2022 Jun 7.
Portal vein thrombosis (PVT) may be associated with negative outcomes in patients with liver cirrhosis. However, the prevalence and incidence of PVT in liver cirrhosis are heterogeneous among studies and have not been sufficiently determined yet.
The PubMed, EMBASE, and Cochrane Library databases were searched. Eligible studies would explore the prevalence and/or incidence of PVT in liver cirrhosis without hepatocellular carcinoma or abdominal surgery. Pooled proportion with 95% confidence interval (CI) was calculated using a random-effect model. Factors associated with the presence/occurrence of PVT were also extracted.
Among the 8549 papers initially identified, 74 were included. Fifty-four studies explored the prevalence of PVT in liver cirrhosis with a pooled prevalence of 13.92% (95%CI=11.18-16.91%). Based on cross-sectional data, Child-Pugh class B/C, higher D-dimer, ascites, and use of non-selective beta-blockers (NSBBs) were associated with the presence of PVT in liver cirrhosis. Twenty-three studies explored the incidence of PVT in liver cirrhosis with a pooled incidence of 10.42% (95%CI=8.16-12.92%). Based on cohort data, Child-Pugh class B/C, higher model of end-stage liver disease score, higher D-dimer, lower platelets count, decreased portal flow velocity, ascites, use of NSBBs, and moderate or high-risk esophageal varices could predict the occurrence of PVT in liver cirrhosis.
Approximately one seventh of cirrhotic patients have PVT, and one tenth will develop PVT. Progression of liver cirrhosis and portal hypertension seems to be in parallel with the risk of PVT. Prospective studies with detailed information about classification and extension of PVT in liver cirrhosis are needed.
门静脉血栓形成（PVT）可能与肝硬化患者的不良结局有关。然而，肝硬化患者中 PVT 的患病率和发病率在不同研究中存在差异，尚未得到充分确定。
检索 PubMed、EMBASE 和 Cochrane 图书馆数据库。合格的研究将探讨无肝细胞癌或腹部手术的肝硬化患者中 PVT 的患病率和/或发病率。使用随机效应模型计算合并比例及其 95%置信区间（CI）。还提取了与 PVT 存在/发生相关的因素。
在最初确定的 8549 篇论文中，有 74 篇被纳入。54 项研究探讨了肝硬化中 PVT 的患病率，其合并患病率为 13.92%（95%CI=11.18-16.91%）。基于横断面数据，Child-Pugh 分级 B/C、较高的 D-二聚体、腹水和使用非选择性β受体阻滞剂（NSBBs）与肝硬化中 PVT 的存在相关。23 项研究探讨了肝硬化中 PVT 的发病率，其合并发病率为 10.42%（95%CI=8.16-12.92%）。基于队列数据，Child-Pugh 分级 B/C、较高的终末期肝病模型评分、较高的 D-二聚体、较低的血小板计数、门静脉血流速度降低、腹水、使用 NSBBs、中度或高度食管静脉曲张可预测肝硬化中 PVT 的发生。
约七分之一的肝硬化患者存在 PVT，十分之一的患者会发生 PVT。肝硬化和门静脉高压的进展似乎与 PVT 的风险平行。需要进行前瞻性研究，详细了解肝硬化中 PVT 的分类和扩展。
