Bai Yaowei, Liu Jiacheng, Lei Yu, Sun Bo, Wu Wenlong, Bai Xiatong, Su Yang, Tan Wei, Kan Xuefeng, Zheng Chuansheng
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China.
Department of Medical Imaging, Geriatric Hospital Affiliated with Wuhan University of Science and Technology, Wuhan 430022, China.
Eur J Radiol. 2025 Sep;190:112212. doi: 10.1016/j.ejrad.2025.112212. Epub 2025 Jun 4.
This study aims to analyze the occurrence of recompensation after transjugular intrahepatic portosystemic shunt (TIPS) for patients with cirrhosis and portal hypertension and its impact on mortality risk.
The clinical data of 621 cirrhotic patients who underwent TIPS creation were retrospectively analyzed. Patients were categorized into a recompensation group (n = 126) and a non-recompensation group (n = 495). Binary logistic regression was used to identify independent predictors of recompensation. Kaplan-Meier (KM) survival curves were employed to assess the differences in survival between the two groups, and the Cox proportional hazards model was utilized to analyze the risk factors for mortality.
At 12 months after TIPS placement, 20.3 % of patients achieved recompensation. The recompensation group demonstrated significant improvements in both Child-Pugh and MELD scores (P < 0.05). Sarcopenia and platelet count (PLT) were identified as independent predictors of recompensation. The cumulative survival rate in the recompensation group was significantly higher than that of the non-recompensation group (HR = 2.275, 95 % CI = 1.606-3.223, Log-rank P < 0.001). Age, sarcopenia, and the occurrence of recompensation were identified as independent factors that influenced mortality risk.
TIPS was associated with recompensation in certain patients, and the occurrence of recompensation is significantly associated with improved long-term survival.
本研究旨在分析肝硬化门静脉高压患者经颈静脉肝内门体分流术(TIPS)后再代偿的发生情况及其对死亡风险的影响。
回顾性分析621例行TIPS手术的肝硬化患者的临床资料。将患者分为再代偿组(n = 126)和非再代偿组(n = 495)。采用二元逻辑回归分析确定再代偿的独立预测因素。采用Kaplan-Meier(KM)生存曲线评估两组患者的生存差异,并利用Cox比例风险模型分析死亡的危险因素。
TIPS置入术后12个月,20.3%的患者实现再代偿。再代偿组患者的Child-Pugh和MELD评分均有显著改善(P < 0.05)。肌肉减少症和血小板计数(PLT)被确定为再代偿的独立预测因素。再代偿组的累积生存率显著高于非再代偿组(HR = 2.275,95%CI = 1.606 - 3.223,Log-rank P < 0.001)。年龄、肌肉减少症和再代偿的发生被确定为影响死亡风险的独立因素。
TIPS与部分患者的再代偿有关,再代偿的发生与长期生存率的提高显著相关。