| Objective 1. To calculate the incidence of portal vein thrombosis(PVT) in patients with liver cirrhosis, realize the clinical characteristics and prognosis; 2. To research the risk factors of PVT in patients with liver cirrhosis; 3. To explore the the indicators that can help forecast the poor prognosis of liver cirrhosis patients with PVT.Methods It was a retrospective study. The data of 770 hospitalized patients diagnosed as liver cirrhosis were collected from January 2008 to December 2014 in gastroenterology department of the the First Affiliated Hospital of Anhui Medical University. 108 cirrhotic patients with non-maligmant PVT were diagnosed according to colour dopple ultrasound or computed tomography or magnetic resonance imaging,then excluded 4 patients who had no integrated data, 5 patients lost to follow-up,finally, 99 patients diagnosed as liver cirrhosis with PVT were enrolled in this study as the PVT group and fo Ilowed up at least for six months.100 patients with liver cirrhosis however no PVT were in control group under a chosen at random during the same period.1. The demographic data, diseases history, family history, operation history,the causes of liver cirrhosis, laboratory examination, imaging tests, clinical feature,conplications and therapeutic schemes of the research objects were all collected to analyze their characteristic. 2. Analyze the influence that PVT had on clinical feature and prognosis of patients with liver cirrhosis by comparing the PVT group and the control group.Screen the risk factors of PVT in cirrhosis by unconditional Logistic regression model.3. Divided 99 patients diagnosed as liver cirrhosis with PVT into the splenectomy group and the non-splenectomy group according to splenectomy history. Research the clinical characteristics of PVT in cirrhosis after splenectomy by comparing the clinical feature, liver function, laboratory examination, complications and prognosis between the two groups.4. According to the outcomes during follow-up, we separated the liver cirrhosis with PVT into death group and the survival group, to explore the risk factors that can forecast poor prognosis of PVT in liver cirrhosis.Results 1. In this research, 99 liver cirrhosis with PVT were found in the 770non-maligmant cirrhotic patients, showing that the incidence of PVT in patients with liver cirrhosis was 12.9%(99/770). PVT was observed mainly in the portal trunk,secondly extending to superior mesenteric vein. 2. The incident rate of abdominal pain, fever, ascites, upper gastrointestinal bleeding in the PVT group were higher than those in the control group, with statistical significance(P=0.034, 0.033, 0.041, 0.001).In the PVT group, 29 patients died during follow-up, and the fatality rate was 29.3%which was significantly higher than the control group(P=0.040, OR=2.02). It presented that the mortality risk of liver cirrhosis with PVT was 2.02 times higher than the patients without PVT in liver cirrhosis. 3. Compared PVT group with non-PVT group,it was of higher frequency for PVT group to show diabetes mellitus,splenectomy, variceal endoscopic sclerotherapy and higher platelet count than the control group, but the PVT group shows lower levels of hemoglobin(P<0.05).Unconditional Logistic regression model analysis indicated that diabetes mellitus,splenectomy, variceal endoscopic sclerotherapy and low levels of hemoglobin had statistical significance(OR=2.244, 3.179, 2.508, 1.013; P=0.039, 0.042, 0.037, 0.020).4. Patients in the splenectomy group showed younger age, longer cirrhosis course,lower Child-Pugh and MELD score than patients in the non-splenectomy group (P<0.05). But there were no statistically significant differences between the two group in clinical feature, complications and mortality(P>0.05). 5. Comparing the data of the death group with the survival group in liver cirrhosis with PVT, it showed that death group had longer hospital stays and more Child-Pugh classification C than survival group(P=0.035, 0.020, <0.05).Conclusion 1. the incidence of PVT in patients with liver cirrhosis was 12.9% in this research. 2. PVT aggravates clinical symptom in liver cirrohsis patients and has bad influence on prognosis. 3. Diabetes mellitus, splenectomy and variceal endoscopic sclerotherapy may be risk factors for PVT. 4. For the liver cirrhosis with portal vein thrombosis, patients with Child-Pugh C and long hospital stays may forcast poor prognosis. |
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