Department of Infectious Diseases, the Hebei Medical University Third Hospital, Shijiazhuang, 050051, China.
BMC Gastroenterol. 2024 Sep 19;24(1):320. doi: 10.1186/s12876-024-03399-1.
To date, there is an ongoing debate regarding the ability to predict PVT development using markers of FVIII or FVIII/PC ratio. This study presents evidence-based medical findings on the influence of FVIII activity levels and FVIII/PC values in the formation of PVT in cirrhosis.
The search for original studies on risk factors for portal vein thrombosis (PVT) associated with cirrhosis was conducted, which primarily focused on comparing circulating FVIII activity levels or FVIII/PC ratio in cirrhotic patients with and without PVT. The quality of evidence from each study was assessed using the Newcastle-Ottawa Scale.
The meta-analysis included a total of 10 original studies. In total, 2250 cirrhotic patients were included, with 414 having PVT and 1836 without PVT. The pooled analysis using a random-effects model showed no significant difference in standardized mean difference (SMD) for FVIII activity levels in cirrhotic patients with or without PVT (SMD = 0.12, 95% CI=-0.46 to 0.70, P = 0.68), but there was significant heterogeneity (I = 95.52%, P = 0.00). Meta-regression analysis indicated that differences in mean FVIII activity levels in the PVT group, the number of cases in the non-PVT group, and the study design methods partially contributed to the heterogeneity (P < 0.05). However, compared to the non-PVT group, the PVT group had higher FVIII/PC ratio with a statistically significant difference (SMD = 0.39, 95% CI: 0.15 to 0.63, P = 0.00), and there was no significant heterogeneity (I = 28.62%).
In conclusion, the FVIII/PC ratio not only reflects the severity of liver disease, but also can be used as one of the predictors of PVT development.
迄今为止，关于使用 FVIII 或 FVIII/PC 比值的标志物预测 PVT 发展的能力，仍存在争议。本研究提供了循证医学证据，证明 FVIII 活性水平和 FVIII/PC 值在肝硬化形成 PVT 中的影响。
对与肝硬化相关的门静脉血栓形成（PVT）危险因素的原始研究进行了检索，主要侧重于比较肝硬化伴或不伴 PVT 的患者循环 FVIII 活性水平或 FVIII/PC 比值。使用纽卡斯尔-渥太华量表评估每个研究的证据质量。
荟萃分析共纳入 10 项原始研究。共纳入 2250 例肝硬化患者，其中 414 例有 PVT，1836 例无 PVT。使用随机效应模型的汇总分析显示，肝硬化患者伴或不伴 PVT 的 FVIII 活性水平标准化均数差（SMD）无显著差异（SMD=0.12，95%CI=-0.46 至 0.70，P=0.68），但存在显著异质性（I=95.52%，P=0.00）。Meta 回归分析表明，PVT 组平均 FVIII 活性水平差异、非 PVT 组病例数以及研究设计方法部分导致了异质性（P<0.05）。然而，与非 PVT 组相比，PVT 组的 FVIII/PC 比值更高，差异具有统计学意义（SMD=0.39，95%CI：0.15 至 0.63，P=0.00），且无显著异质性（I=28.62%）。
综上所述，FVIII/PC 比值不仅反映了肝脏疾病的严重程度，还可作为 PVT 发展的预测因子之一。
