Cirrhosis Portal Hypertension Liver Fibrosis Before And After TIPs Change Analysis Of Indicators

Objective:To explore whether TIPS can alleviate the progression of liver fibrosis and liver cirrhosis by analyzing the changes of liver fibrosis indexes before and after TIPS in patients with portal hypertension of liver cirrhosis.Methods:The inclusion criteria and exclusion criteria were strictly adopted,and the 54 patients who underwent TIPS were included as research subjects.They were randomly divided into two groups according to the decompensation and decompensation of liver cirrhosis.Among them,17 patients in the decompensation group of liver cirrhosis and 12 patients in the decompensation group of liver cirrhosis were divided into 10 patients with grade A liver function and 15 patients with grade B liver function according to child-pugh grading.The observation indexes were sodium hyaluronate(HA),laminin(LN),type iii procollagen(PIIINP),and type IV collagen(IVC).Results:There was no significant difference in HA,LN,PIIINP between decompensated group and decompensated group at preoperative and postoperative time points(P > 0.05),while there was significant difference in IVC preoperative comparison(P < 0.05).There were statistically significant differences between the decompensated HA group at 6 months and 12 months after surgery and 1 week after surgery(P < 0.05),and the difference was lower at 6 months and 12 months after surgery than 1 week after surgery.There were statistically significant differences between the compensatory group and the preoperative group at 1 and 3 months after surgery,and between the postoperative group and the postoperative group at 6 and 3 months after surgery(P < 0.05).PIIINP in the compensatory group was significantly higher 1 month,3 months and 6 months after surgery than before(P < 0.05).There were statistically significant differences between the two groups(P < 0.05),and the IVC level was higher 1 month and 3 months after surgery than before surgery.There was no significant difference in HA between group A and group B before and after surgery(P > 0.05).There was A statistically significant difference between the liver function level A group at 3,6 and 12 months after surgery and 1 week after surgery(P < 0.05),and the liver function level A group at 3,6 and 12 months after surgery was lower than that at 1 week after surgery.There was a statistical difference between the liver function grade B group 12 months after the operation and 1 week after the operation(P < 0.05),and the liver function grade B group 12 months after the operation was lower than 1 week after the operation.There were statistically significant differences in LN between grade A group and grade B group at 6 months and 12 months after surgery(P < 0.05),and liver function grade A group was lower than that of grade B group.There was A statistically significant difference in liver function between group A and group B at 1 month and 6 months after surgery(P < 0.05),and the difference was statistically significant between group A and group B at 1 month after surgery(P < 0.05),and between group A and group B at 3 months after surgery(P < 0.05),and between group A and group B at 3 months after surgery(P < 0.05).There was A statistically significant difference in PIIINP between the liver function grade A group and the liver function grade B group before and 1 week after surgery(P < 0.05),and the liver function grade A group was lower than the liver function grade B group.There were statistically significant differences in PIIINP between the group A and the preoperative group at 1 and 12 months after the operation(P < 0.05),and the PIIINP increased at 1 and 12 months after the operation compared with that before the operation.There was A statistically significant difference in IVC between the liver function grade A group and the liver function grade B group before and 1 week after surgery(P < 0.05),and the liver function grade A group was lower than that of the liver function grade B group.There was A statistically significant difference between the liver function group A and the preoperative group 1 month and 3 months after the operation(P < 0.05),and the liver function was increased 1 month and 3 months after the operation compared with that before the operation.Conclusion: 1.After TIPS,the portal vein blood flow is reduced,the blood flow to the liver is reduced,short-term hepatocyte ischemia and hypoxia,liver function is decreased,and the fibrosis index is increased,while the middle-long term portal hypertension is improved,and the liver blood flow is redistributed,improving ischemia and hypoxia,liver function is improved,and the fibrosis index is reduced;2.TIPS can not only treat portal hypertension complications of liver cirrhosis,but also stabilize or delay the progression of liver fibrosis and liver cirrhosis.Monitoring the changes of fibrosis indexes after TIPS has certain clinical significance.