Influencing Factors For Hepatic Venous Pressure Gradient In Patients With Cirrhotic Portal Hypertension

Objective:To analysis the clinical influencing factors for Hepatic Venous Pressure Gradient(HVPG)in patients with cirrhotic portal hypertension.Method:A total of 158 patients with cirrhotic portal hypertension who underwent Transjugular Intrahepatic Portosystemic Shunt(TIPS)in The General Hospital of Western Theater Command of the People's Liberation Army of China from January 2015 to December 2018 were enrolled.General information of patients(gender,age,etiology of liver cirrhosis,history of upper gastrointestinal bleeding,history of endoscopic treatment,hepati cencephalopathy(HE),blood biochemical indicators(hemoglobin(HGB),white blood cells(WBC),platelets(PLT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),Total bilirubin(TBIL),prothrombin time(PT),Child-Pugh score,Model for end-stage liver disease score(MELD score),endoscopic results(esophageal varices,gastric varices,red color sign),ultrasound results(ascites)were collected.Wedged hepatic venous pressure(WHVP),Free hepatic venous pressures(FHVP)and Portal venous pressure(PVP)were measured during TIPS,and HVPG and Portal venous pressure gradient(PVPG)were calculated.The independent sample t test was used for the comparison between the two groups.One-way analysis of variance followed by least-significant difference t test was the method used to compare the different study groups.The Pearson correlation coefficient was used to analyze the correlation between HVPG and PVPG,and a multivariate linear regression analysis was used to investigate independent risk factors for HVPGResults:In 158 patients with cirrhotic portal hypertension,HVPG was 22.84±4.58 mmHg and PVPG was 23.24±4.81 mmHg.Pearson correlation analysis showed HVPG was positively correlated with PVPG(r=0.796,P<0.001).One-way analysis of variance showed Age and etiology of liver cirrhosis were influencing factor for HVPG(both P<0.001).HVPG was lower in patients with<40 years,and HVPG was higher in patients with ?60 years.HVPG was gradually increasing with the increase of patients' age.HVPG was higher in patients with chronic hepatitis C cirrhosis than in those with cirrhosis due to chronic hepatitis B,alcohol and other causes.Independent sample t test showed gender,history of upper gastrointestinal bleeding,history of endoscopic treatment,HE,ALT,AST,MELD score,gastric varices and red color signs had no significant effect on HVPG(P=0.106,0.545,0.159,0.588,0.492,0.234,0.600,0.264,respectively).One-way analysis of variance showed HGB,WBC,PLT,ALB,TBIL,PT,Child-Pugh score,esophageal varices and ascites had no significant effect on HVPG(P=0.988,0.617,0.588,0.164,0.553,0.466,0.091,0.523,0.628,respectively).The multivariate linear regression analysis showed that age and etiology of liver cirrhosis were independent influencing factors for HVPG(both P<0.001).Conclusion:1.HVPG was positively correlated with PVPG in patients with cirrhotic portal hypertension.2.Age and etiology of liver cirrhosis were independent factors affecting HVPG in patients with cirrhosis portal hypertension.Older or chronic hepatitis C cirrhosis patients with cirrhotic portal hypertension had higher HVPG.3.Gender,history of upper gastrointestinal bleeding,history of endoscopic treatment,HE,HGB,WBC,PLT,ALT,AST,ALB,TBIL,PT,Child-Pugh score,MELD score,esophageal varices,gastric varices,red color sign and ascites had no significant effect on HVPG in patients with cirrhotic portal hypertension.