Risk factors for non－neoplastic portal vein thrombosis in patients with liver cirrhosis

Tianfu LIU; Liang WANG; Lingyi ZHANG

doi:10.3969/j.issn.1001-5256.2023.09.014

Volume 39 Issue 9

Sep. 2023

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2023 > 39(9): 2122-2127

PDF( 591 KB)

Risk factors for non－neoplastic portal vein thrombosis in patients with liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2023.09.014

Department of Hepatology，The Second Hospital of Lanzhou University，Lanzhou 730030，China

Research funding:

Education Technology Innovation Project of Gansu Province (2022B－047);

Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital (CY2021－QN－A18)

More Information

Corresponding author: ZHANG Lingyi， zhanglymd@126.com （ORCID： 0000－0002－0434－7533）
Received Date: 2023-02-08
Accepted Date: 2023-03-08
Published Date: 2023-09-19

Abstract

Abstract

Objective To investigate the risk factors for non－neoplastic portal vein thrombosis （PVT） in patients with liver cirrhosis and related early predictive factors. Methods A total of 50 cirrhotic patients with non－neoplastic PVT who were hospitalized and treated in Department of Hepatology， The Second Hospital of Lanzhou University， from July 1， 2021 to June 30， 2022 were enrolled as PVT group， and 100 cirrhotic patients without PVT who were treated during the same period of time were randomly selected as control group. Related clinical data were collected. The independent－samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann－Whitney U test was used for comparison of non－normally distributed continuous data between two groups； the chi－square test was used for comparison of categorical data between two groups. A multivariate Logistic regression model analysis was used to investigate the influencing factors for PVT in liver cirrhosis， and the receiver operating characteristic curve was used to evaluate the predictive performance of influencing factors. Results The univariate analysis showed that there were no significant differences between the two groups in the indicators such as protein C， protein S， prothrombin time， international standardized ratio， fibrinogen， white blood cell count， platelet count， and biochemical parameters （all P>0.05）， while there were significant differences between the two groups in history of splenectomy， history of endoscopic treatment of esophageal and gastric varices， history of hepatic encephalopathy， administration of non－selective β－blocker （NSBB）， D－dimer， hemoglobin， and triglyceride （all P<0.05）. The multivariate Logistic regression model analysis showed that D－dimer （odds ratio ［OR］＝1.120， 95% confidence interval ［CI］： 1.006－1.246， P＝0.038）， history of splenectomy （OR＝9.320， 95% CI： 2.928－29.665， P<0.001）， history of hepatic encephalopathy （OR＝16.813， 95% CI： 1.808－156.336， P＝0.013）， and administration of NSBB （OR＝3.203， 95% CI： 1.020－10.051， P＝0.046） were independent risk factors for PVT. Conclusion Elevated D－dimer， history of splenectomy， history of hepatic encephalopathy， and administration of NSBB are predictive factors for non－neoplastic PVT in patients with liver cirrhosis.
- Liver Cirrhosis,
- Venous Thrombosis,
- Risk Factors

FullText(HTML)

References(23)

References

[1]	TURON F, DRIEVER EG, BAIGES A, et al. Predicting portal thrombosis in cirrhosis: A prospective study of clinical, ultrasonographic and hemostatic factors[J]. J Hepatol, 2021, 75( 6): 1367－ 1376. DOI: 10.1016/j.jhep.2021.07.020.
[2]	Hepatobiliary Disease Study Group, Chinese Society of Gastroenterology, Chinese Medical Association. Consensus for management of portal vein thrombosis in liver cirrhosis(2020,Shanghai)[J]. J Clin Hepatol, 2020, 36( 12): 2667－ 2674. DOI: 10.3969/j.issn.1001－5256.2020.12.007. 中华医学会消化病学分会肝胆疾病学组. 肝硬化门静脉血栓管理专家共识(2020年, 上海)[J]. 临床肝胆病杂志, 2020, 36( 12): 2667－ 2674. DOI: 10.3969/j.issn.1001－5256.2020.12.007.
[3]	Chinese Society of Hepatology, Chinese Medical Association. Chinese guidelines on the management of liver cirrhosis[J]. J Clin Hepatol, 2019, 35( 11): 2408－ 2425. DOI: 10.3969/j.issn.1001－5256.2019.11.006. 中华医学会肝病学分会. 肝硬化诊治指南[J]. 临床肝胆病杂志, 2019, 35( 11): 2408－ 2425. DOI: 10.3969/j.issn.1001－5256.2019.11.006.
[4]	SENZOLO M, GARCIA－TSAO G, GARCÍA－PAGÁN JC. Current knowledge and management of portal vein thrombosis in cirrhosis[J]. J Hepatol, 2021, 75( 2): 442－ 453. DOI: 10.1016/j.jhep.2021.04.029.
[5]	NICOARĂ－FARCĂU O, SOY G, MAGAZ M, et al. New insights into the pathogenesis, risk factors, and treatment of portal vein thrombosis in patients with cirrhosis[J]. Semin Thromb Hemost, 2020, 46( 6): 673－ 681. DOI: 10.1055/s－0040－1715473.
[6]	TRIPODI A, MANNUCCI PM. The coagulopathy of chronic liver disease[J]. N Engl J Med, 2011, 365( 2): 147－ 156. DOI: 10.1056/NEJMra1011170.
[7]	ZHANG D, HAO J, YANG N. Protein C and D－dimer are related to portal vein thrombosis in patients with liver cirrhosis[J]. J Gastroenterol Hepatol, 2010, 25( 1): 116－ 121. DOI: 10.1111/j.1440－1746.2009.05921.x.
[8]	ZHANG DL, HAO JY, YANG N. Value of D－dimer and protein S for diagnosis of portal vein thrombosis in patients with liver cirrhosis[J]. J Int Med Res, 2013, 41( 3): 664－ 672. DOI: 10.1177/0300060513483413.
[9]	KAWANAKA H, AKAHOSHI T, KINJO N, et al. Impact of antithrombin III concentrates on portal vein thrombosis after splenectomy in patients with liver cirrhosis and hypersplenism[J]. Ann Surg, 2010, 251( 1): 76－ 83. DOI: 10.1097/SLA.0b013e3181bdf8ad.
[10]	SHU D, HUANG XR, JIANG YJ, et al. Logistic regression analysis of risk factors for portal vein thrombosis in liver cirrhosis[J]. Chin Hepatol, 2019, 24( 7): 740－ 743. DOI: 10.3969/j.issn.1008－1704.2019.07.007. 舒丹, 黄湘荣, 蒋育进, 等. 肝硬化门静脉血栓形成高危因素的Logistic回归分析[J]. 肝脏, 2019, 24( 7): 740－ 743. DOI: 10.3969/j.issn.1008－1704.2019.07.007.
[11]	HUNG HC, LEE JC, CHENG CH, et al. Protein S for portal vein thrombosis in cirrhotic patients waiting for liver transplantation[J]. J Clin Med, 2020, 9( 4): 1181. DOI: 10.3390/jcm9041181.
[12]	CHEN H, QI X, HE C, et al. Coagulation imbalance may not contribute to the development of portal vein thrombosis in patients with cirrhosis[J]. Thromb Res, 2013, 131( 2): 173－ 177. DOI: 10.1016/j.thromres.2012.11.003.
[13]	TANG W, WANG Y, ZHAO X, et al. Procoagulant imbalance aggravated with falling liver function reserve, but not associated with the presence of portal vein thrombosis in cirrhosis[J]. Eur J Gastroenterol Hepatol, 2015, 27( 6): 672－ 678. DOI: 10.1097/MEG.0000000000000352.
[14]	QI X, HAN G, YE C, et al. Splenectomy causes 10－fold increased risk of portal venous system thrombosis in liver cirrhosis patients[J]. Med Sci Monit, 2016, 22: 2528－ 2550. DOI: 10.12659/msm.898866.
[15]	LI LJ, WANG S, WEN ZF, et al. Risk factors of portal vein thrombosis after cyanoacrylate injection for gastric varices[J]. J Sun Yat－Sen Univ(Med Sci), 2015, 36( 6): 936－ 942. 李雷佳, 王省, 文卓夫, 等. 胃底静脉曲张组织黏合剂注射术后门静脉血栓形成的危险因素分析[J]. 中山大学学报(医学科学版), 2015, 36( 6): 936－ 942.
[16]	SHEN DJ, QIAN XX, WANG J, et al. Risk factor analysis of non－acute symptomatic portal vein thrombosis after endoscopic gastric variceal injection[J]. J Chin Physician, 2021, 23( 3): 338－ 342. DOI: 10.3760/cma.j.cn431274－20210129－00140. 沈丹杰, 钱孝先, 王剑, 等. 内镜下胃底静脉曲张注射治疗术后非急性症状性门静脉血栓形成的危险因素分析[J]. 中国医师杂志, 2021, 23( 3): 338－ 342. DOI: 10.3760/cma.j.cn431274－20210129－00140.
[17]	ZHOU ZL, YANG LN, LI QQ, et al. Research advances in the early predictive factors for non－neoplastic portal vein thrombosis in liver cirrhosis[J]. J Clin Hepatol, 2022, 38( 9): 2150－ 2154. DOI: 10.3969/j.issn.1001－5256.2022.09.039. 周遵兰, 杨丽娜, 李清清, 等. 肝硬化患者非肿瘤性门静脉血栓形成的早期预测因子[J]. 临床肝胆病杂志, 2022, 38( 9): 2150－ 2154. DOI: 10.3969/j.issn.1001－5256.2022.09.039.
[18]	STINE JG, WANG J, SHAH PM, et al. Decreased portal vein velocity is predictive of the development of portal vein thrombosis: A matched case－control study[J]. Liver Int, 2018, 38( 1): 94－ 101. DOI: 10.1111/liv.13500.
[19]	XU X, GUO X, DE STEFANO V, et al. Nonselective beta－blockers and development of portal vein thrombosis in liver cirrhosis: a systematic review and meta－analysis[J]. Hepatol Int, 2019, 13( 4): 468－ 481. DOI: 10.1007/s12072－019－09951－6.
[20]	NERY F, CORREIA S, MACEDO C, et al. Nonselective beta－blockers and the risk of portal vein thrombosis in patients with cirrhosis: results of a prospective longitudinal study[J]. Aliment Pharmacol Ther, 2019, 49( 5): 582－ 588. DOI: 10.1111/apt.15137.
[21]	NORONHA FERREIRA C, MARINHO RT, CORTEZ－PINTO H, et al. Incidence, predictive factors and clinical significance of development of portal vein thrombosis in cirrhosis: A prospective study[J]. Liver Int, 2019, 39( 8): 1459－ 1467. DOI: 10.1111/liv.14121.
[22]	LOPEZ－GOMEZ M, LLOP E, PUENTE A, et al. Non－malignant portal vein thrombosis in a cohort of cirrhotic patients: Incidence and risk factors[J]. Hepatol Res, 2021, 51( 10): 1064－ 1072. DOI: 10.1111/hepr.13703.
[23]	FACCIA M, SANTOPAOLO F, GASBARRINI A, et al. Risk factors for portal vein thrombosis or venous thromboembolism in a large cohort of hospitalized cirrhotic patients[J]. Intern Emerg Med, 2022, 17( 5): 1327－ 1334. DOI: 10.1007/s11739－022－02928－8.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Tables(3)

Get Citation

PDF

XML

Article Metrics

Article views (305) PDF downloads(61)

Risk factors for non－neoplastic portal vein thrombosis in patients with liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2023.09.014

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content