The Risk Factors And Logistic Regression Predict Model Of Portal Vein Thrombosis In Patients With Liver Cirrhosis

Objective:To investigate the related risk factors of portal vein thrombosis(PVT)in patients with liver cirrhosis.Methods:A total of 39 patients with liver cirrhosis complicated by PVT who were diagnosed from January 2012 to February 2016 were enrolled as PVT group,and 384 cirrhotic patients without PVT were enrolled as controls(non-PVT group).The general information,laboratory and imaging results of the patients were collected,compared the incidence of related complications of the two groups,screening out the related factors.The measurement data were compared with independent samples T test,and the count data were compared with chi square test,and the last independent risk factors were analyzed by non conditional logistic regression.Based on the multivariate analysis results,we draw relevant ROC curve,Logistic regression predict model was established and its value would be evaluated on predicting PVT of these patients.Results:There were significant differences between the PVT group and non-PVT group in age,body mass index、non selective beta blockers,splenic operations,esophageal variceal ligation,Child-Pugh score,white blood cell,platelet distribution width,hemoglobin、 gamma glutamyl transpeptidase,portal vein diameter,thickness of spleen,spleen diameter,Splenic portal vein diameter,ascites volume(all P<0.05).The PVT groups were more likely to happen portal hypertension gastropathy,esophageal varices,alimentary tract hemorrhage complications.The non conditional logistic regression model analysis showed that the GTT was the protective factor(P<0.05,OR =0.976),diameter of portal vein(P<0.05,OR =1.419),portal hypertension gastropathy(P<0.05,OR =6.766),upper gastrointestinal bleeding history(P<0.05,OR =5.546)were the independent risk factors of cirrhosis PVT formation.Logistic regression predict model established according to the above factors was expressed as LogitP=2.031-0.025γ-GT(U/L)+0.35MPV(mm)+1.912PHG(Yes=1,No=0)+1.713UGIB(Yes=1,No=0),the area under the receiver operating characteristic curve(AUC)and the accuracy were 0.817 and 82.742%.Conclusion:The gamma-glutamyltransferase decreased could reduce the risk of turning out PVT.The diameter of the main portal vein was widened,and the history of portal hypertension gastropathy and upper gastrointestinal bleeding would increase the risk of turning out PVT.So the key to prevent the formation of portal vein thrombosis in patients with cirrhosis is to reduce the pressure of portal vein.The Logistic regression predict model has a higher predictive value,it provided mathematical model for predicting PVT.