Study On Risk Factors Of Portal Vein System Thrombosis In Early Stage Of Acute Pancreatitis

Objective:To investigate the risk factors of portal vein system thrombosis(PVST)in early acute pancreatitis(AP).Methods:A retrospective case-control study was used to collect and analyze patients who received treatment for acute pancreatitis in the First Affiliated Hospital of Xinjiang Medical University from January 2019 to December 2021.A total of 142 inpatients with acute pancreatitis who met the inclusion criteria and had complete clinical data were included.In the early stage of the disease,the clinical results of patients with acute pancreatitis with and without portal vein system thrombosis were compared.Univariate and multivariate logistic regression analyses was performed in turn to evaluate the potential risk factors for portal vein system thrombosis in patients with early acute pancreatitis.For eligible independent risk factors,the A receiver operating characteristic(ROC)curve was generated.Results: Among 142 patients with acute pancreatitis,29(20.4%)developed portal vein system thrombosis on 5.52 ± 3.04 days after the onset of acute pancreatitis(AP).Portal vein system thrombosis was confirmed by abdominal enhanced CT or three-dimensional reconstruction.Multiple logistic regression analysis showed that Balthazar CT score(OR=1.725;95% CI=1.263-2.357;P=0.001),hematocrit(OR=1.066;95% CI=1.020-1.114;P=0.049),and albumin level(OR=0.857;95% CI=0.784-0.937;P=0.010)were independent risk factors for PVST in AP patients.The analysis results of the subject work characteristic curve(ROC)showed that the area under the ROC curve of the Balthazar CT score was 0.750(P<0.001),with a sensitivity of96.6%,and a specificity of 46.9% when the cut-off value was 4.5.The area under the ROC curve for hematocrit was 0.663(P=0.004),with a sensitivity of 75.9% and a specificity of53.1% at a cut-off value of 37.9.The area under the ROC curve for albumin levels was0.770(P<0.001),with a sensitivity of 79.3% and a specificity of 67.3% at a cut-off value of 29.7.It can be seen that the protein level is more valuable in predicting acute pancreatitis with PVST.Conclusion:Balthazar CT score,hematocrit,and albumin level are independent risk factors for PVST in AP patients,and the incidence of PVST in early AP patients with high Balthazar CT score,high hematocrit,and low albumin level is high.The incidence of complications in inpatients with acute pancreatitis combined with PVST is significantly higher than that in patients without thrombus,including pancreatic necrosis,liver injury,ketoacidosis,etc.The incidence of hospital death in the thrombosis group was higher than that in the non thrombosis group.