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韩国炎症性肠病患者门静脉血栓形成的特征及转归

Characteristics and outcomes of portal vein thrombosis in patients with inflammatory bowel disease in Korea.

作者信息

Kim Ki Jin, Song Su-Bin, Park Jung-Bin, Bae June Hwa, Baek Ji Eun, Kim Ga Hee, Kim Min-Jun, Hong Seung Wook, Hwang Sung Wook, Yang Dong-Hoon, Ye Byong Duk, Byeon Jeong-Sik, Myung Seung-Jae, Yang Suk-Kyun, Yu Chang Sik, Yoon Yong-Sik, Lee Jong-Lyul, Kim Min Hyun, Lee Ho-Su, Park Sang Hyoung

机构信息

Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Korean J Intern Med. 2025 Mar;40(2):243-250. doi: 10.3904/kjim.2024.181. Epub 2024 Dec 23.

Abstract

BACKGROUND/AIMS: Portal vein thrombosis (PVT) frequently occurs in patients with inflammatory bowel disease (IBD), particularly when influenced by factors such as abdominal infections, IBD flare-ups, or surgical procedures. The implications of PVT range from immediate issues such as intestinal ischemia to long-term concerns including portal hypertension and its complications. However, there is a notable gap in comprehensive studies on PVT in IBD, especially with the increasing incidence of IBD in Asia. This research aimed to evaluate the clinical features and outcomes of PVT in patients with IBD at a leading hospital in South Korea.

METHODS

This retrospective analysis reviewed adult patients diagnosed with both IBD and PVT from 1989 to 2021 at a renowned South Korean medical center. The study focused on patient characteristics, specifics of PVT, administered treatments, and outcomes, all confirmed through enhanced CT scans.

RESULTS

A total of 78 patients met the study's criteria. Notably, only 20.5% (16/78) were treated with oral anticoagulants; however, a vast majority (96.2%; 75/78) achieved complete radiographic resolution (CRR). When comparing patients receiving anticoagulants to those who did not, a significant preference for anticoagulant use was observed in cases where the main portal vein was affected, as opposed to just the left or right veins (p = 0.006). However, multivariable analysis indicated that neither anticoagulant use nor previous surgeries significantly impacted CRR.

CONCLUSION

Patients with IBD and PVT generally had favorable outcomes, regardless of anticoagulant use.

摘要

背景/目的:门静脉血栓形成(PVT)在炎症性肠病(IBD)患者中经常发生,尤其是在受到腹部感染、IBD发作或外科手术等因素影响时。PVT的影响范围从诸如肠缺血等即刻问题到包括门静脉高压及其并发症在内的长期问题。然而,关于IBD中PVT的综合研究存在显著空白,特别是在亚洲IBD发病率不断上升的情况下。本研究旨在评估韩国一家领先医院中IBD合并PVT患者的临床特征和预后。

方法

这项回顾性分析纳入了1989年至2021年在韩国一家知名医疗中心被诊断为IBD和PVT的成年患者。该研究聚焦于患者特征、PVT的具体情况、所采用的治疗方法以及预后,所有这些均通过增强CT扫描得以证实。

结果

共有78名患者符合研究标准。值得注意的是,只有20.5%(16/78)的患者接受了口服抗凝剂治疗;然而,绝大多数(96.2%;75/78)患者实现了影像学完全缓解(CRR)。在比较接受抗凝剂治疗的患者与未接受治疗的患者时,发现主门静脉受累的病例与仅左或右门静脉受累的病例相比,抗凝剂使用存在显著差异(p = 0.006)。然而,多变量分析表明,抗凝剂的使用和既往手术均未对CRR产生显著影响。

结论

IBD合并PVT的患者,无论是否使用抗凝剂,总体预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6606/11938685/9f41f2b5e07f/kjim-2024-181f1.jpg

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