Study Of Hepatitis B Cirrhosis Complicated With Renal Injury And Portal Vein Blood Flow Characteristics And Associated Risk Factors

Objective:Analyze the blood flow characteristics of portal system and related risk factors in hepatitis B cirrhosis patients complicated with renal injury to investigate the independent risk factors of patients with hepatitis B cirrhosis complicated with renal damage so as to provide the basis for early prevention and treatment.Methods : This study was a retrospective study.Information of 210 hepatitis B cirrhosis patients who were admitted to the Department of Gastroenterology and Hepatology of the First Hospital of Changsha City from December 2018 to December 2020 and met the inclusion and exclusion criteria were collected.e GFR was calculated according to the CKD-EPI formula.The patients were divided into two groups: renal injury group(62 patients)and without renal injury group(148 patients).The evaluation indexes,including gender,age,RBC,WBC,NEUT,HB,PLT,ALT,AST,TC,TG,ALB,TBIL,Scr,BUN,URIC,Na,K,CL,Ca,Dpv,Dsmv,Dsv,Vpv,Vsmv,Vsv,grade of ChildPugh and HBV-DNA,were collected for the further study of risk factors of hepatitis B cirrhosis complicated with renal injury.Result:1.The mean age of renal injury group was(60.00±11.87)while without renal injury group was(48.91±9.35),with statistical difference(P <0.01).2.Comparison of laboratory indexes between the two groups showed that the levels of WBC,NEUT,HB,TG,Scr,BUN and URIC in renal injury group were higher than those in without renal injury group,while the levels of HB and ALB were lower.The difference was statistically significant(P < 0.05).3.Comparison of portal hemodynamics between the two groups showed that the Dpv and Qpv levels of the renal injury group were higher than those of without renal injury group,with statistical difference(P < 0.05).4.Comparison of portal complication between the two groups showed that hypoproteinemia,hyperuricemia,hypokalemia,hyponatremia and anemia were more likely to occur in renal injury,with statistical difference(P < 0.05).5.Dpv(OR=2.824,P =0.000),TG(OR=2.764,P= 0.009),age(OR=1.117,P = 0.000),hyponatremia(OR=9.628,P=0.009)and hyperuricemia(OR=3.730,P=0.016)were independent risk factors for hepatitis B cirrhosis complicated with renal injury.6.The area under the renal injury curve predicted by Dpvwas 0.823(P <0.05).The cut off value was calculated to be 1.25 cm with sensitivity of 79.0%and specificity of 79.1%.The area under the renal injury curve predicted by TG was 0.589(P < 0.05).The cut off value was calculated to be 1.10g/dl with sensitivity of 50.0% and specificity of 70.3%.The area under the renal injury curve predicted by age was 0.769(P < 0.05).The cut off value was calculated to be 53.5 with sensitivity of 71.0% and specificity of 67.6%.Conclusion:1.When kidney injury occurs in patients with hepatitis B cirrhosis,the elevation of DPV and QPV in portal vein system is more obvious.2.Dpv,TG,age,hyperuricemia and hyponatremia were maybe independent risk factors for hepatitis B cirrhosis complicated with renal injury;Dpv greater than 1.25 cm,TG greater than 1.1mmol/ L and age greater than 53.5maybe increased the risk of renal injury in hepatitis B cirrhosis patients.