肝硬化门静脉血栓形成的相关因素分析。
Analysis of related factors of portal vein thrombosis in liver cirrhosis.
机构信息
Department of Hepatology, The First Hospital of Jilin University, Changchun, China.
出版信息
BMC Gastroenterol. 2023 Jan 30;23(1):26. doi: 10.1186/s12876-022-02632-z.
BACKGROUND AND AIMS
To investigate the usefulness of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), protein C (PC), and thromboelastography (TEG) to serve as a predictor of portal vein thrombosis (PVT) in patients with liver cirrhosis. Additionally, we examined the clinical significance of the above indicators in terms of disease progression.
METHODS
A total of 123 patients with liver cirrhosis were recruited from May 2021 to December 2021, according to the imaging findings. They were divided into the PVT group (n = 52) and the non-PVT group (n = 71). Furthermore, patients with PVT were divided into plasma transfusion groups (n = 13) and non-plasma transfusion groups (n = 39). The basic general information, past medical history, laboratory, and imaging examination data were collected and analyzed.
RESULTS
In univariate analysis, there was no significant difference between the two groups in IL-6, PC, reaction time (R), alpha angle (Angle), maximum amplitude, or coagulation index (CI) (P > 0.05). TNF-α in the PVT group was significantly lower than that in the non-PVT group (P = 0.001). K-time (K) in the PVT group was significantly higher than that in the non-PVT group (P = 0.031). There was no significant difference in IL-6, TNF-α, PC, or TEG between different Child-Pugh classification groups (P > 0.05). There were no significant differences in TEG between the plasma transfusion group and the non-plasma transfusion group. In Binary logistic regression analysis, TNF-α (OR = 0.9881, 95%CI = 0.971, 0.990, P < 0.001), K(OR = 1.28, 95% = 1.053, 1.569, P = 0.014), activate partial thromboplastin time (APTT) (OR = 0.753, 95%CI = 0.656, 0.865, P < 0.001), portal vein diameter (OR = 1.310, 95%CI = 1.108, 1.549, P = 0.002)and the history of splenectomy or embolism (OR = 7.565, 95%CI = 1.514, 37.799, P = 0.014)were related to the formation of PVT.
CONCLUSIONS
TNF-α, K, APTT, portal vein diameter, and splenectomy or embolism history were associated with PVT formation, but IL-6 was not.
背景与目的
探讨白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、蛋白 C（PC）和血栓弹力图（TEG）在预测肝硬化患者门静脉血栓形成（PVT）中的作用，并分析这些指标在疾病进展方面的临床意义。
方法
选取 2021 年 5 月至 2021 年 12 月根据影像学检查结果确诊的 123 例肝硬化患者为研究对象。根据影像学检查结果，将患者分为 PVT 组（n=52）和非 PVT 组（n=71）。进一步根据治疗方法将 PVT 组患者分为血浆输注组（n=13）和非血浆输注组（n=39）。收集并分析患者的基本一般资料、既往病史、实验室和影像学检查数据。
结果
单因素分析结果显示，两组患者的 IL-6、PC、反应时间（R）、α角（Angle）、最大振幅和凝血指数（CI）比较，差异均无统计学意义（P>0.05）；PVT 组患者的 TNF-α水平明显低于非 PVT 组（P=0.001）。PVT 组患者的 K 时间（K）明显长于非 PVT 组（P=0.031）。不同 Child-Pugh 分级组患者的 IL-6、TNF-α、PC 或 TEG 比较，差异均无统计学意义（P>0.05）。血浆输注组和非血浆输注组患者的 TEG 比较，差异无统计学意义。二元逻辑回归分析结果显示，TNF-α（OR=0.9881，95%CI=0.971，0.990，P<0.001）、K（OR=1.28，95%CI=1.053，1.569，P=0.014）、活化部分凝血活酶时间（APTT）（OR=0.753，95%CI=0.656，0.865，P<0.001）、门静脉直径（OR=1.310，95%CI=1.108，1.549，P=0.002）和脾切除术或栓塞史（OR=7.565，95%CI=1.514，37.799，P=0.014）与 PVT 的形成有关。
结论
TNF-α、K、APTT、门静脉直径和脾切除术或栓塞史与 PVT 的形成有关，而 IL-6 与 PVT 的形成无关。
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