The Clinical Characteristics Of Portal Vein Thrombosis In Patients With Liver Cirrhosis

Background and aims: Portal vein thrombosis refers to the formation of a thrombus in the main portal vein or involving the superior mesenteric vein,spleen vein and(or),which is formed by the inferior mesenteric vein thrombosis,it is one of the complications of portal hypertension in patients with decompensated liver cirrhosis,which can result in sudden severe abdominal pain,acute gastroesophageal bleeding when it is severe.If the thrombosis involves mesentery,it is easy to cause the bowel ischemia,necrosis and obstruction,which affects the patient’s quality of life seriously.With the progress of imaging technology,the detection rate of PVT in patients with liver cirrhosis is increasing year by year,but the etiology and pathogenesis of PVT is still unclear,and scholars at home and abroad don’t have a unified opinion of the predictors for how to detect PVT with liver cirrhosis effectively,sometimes even opposite.By retrospective investigation and analysis,our study compared the differences of two groups,which were thrombosis group and nothrombosis group,then analysed the clinical characteristics of portal vein thrombosis in patients with liver cirrhosis,to enhance the clinical doctor’s emphasis on liver cirrhosis complicated with PVT for early diagnosis and treatment.Materials and methods: We selected medical records of hospitalized patients with liver cirrhosis by our hospital’s records system from January 1,2017 to December 31,2017 in our department of hepatology from the first hospital of Jilin university.According to the inclusion and exclusion criteria,a total of 376 patients with liver cirrhosis were identified and divided into cirrhotic patents with PVT(thrombosis group)and cirrhotic patients without PVT(no-thrombosis group/control group)from the results of imaging examination.Collected and compared the clinical data of two groups with statistical analysis.Results:1、Among the 376 patients,52 patients developed PVT and control group included 324 patients.The incidence of PVT in patients with liver cirrhosis was 13.8%.2、Gender,age,history of diabetes,the etiology of liver cirrhosis,ascites,albumin levels,platelet count and blood coagulation function were similar in both groups.3 、 There were 9 patients undergoing splenectomy in thrombosis group,accounting for 17.3% of this group,and there were 20 patients with splenectomy in control group,accounting for 6.1% of the number in the group,using chi-square after comparing the two groups showed significant statistical differences(P<0.05).4、There were 19 patients occurring gastrointestinal bleeding in thrombosis group,accounting for 36.5%,and 51 patients with gastrointestinal bleeding in control group,accounting for 15.7% of this group,the significant differences were statistically between two groups(P<0.05).5、Comparing the two groups of collateral circulation openness,width of portal vein and thickness of the spleen,and finding they were statistically differences(P<0.05).6、The value of hemoglobin(HGB),Asparta transaminase(AST)and Alpha fetoprotein(AFP)in thrombosis group were lower than those of control group,but red blood cell distribution width(RDW)was higher than this of control group,there were statistical differences between the two groups(P<0.05).7、It was showed that the width of portal vein and collateral circulation were the independent risk factor for the formation of PVT with liver cirrhosis from multivariate analysis by Logistic regression model(P<0.05),and combined with the regression coefficient(B)and the value of OR could be concluded that there were positive correlation between the formation of PVT with liver cirrhosis and the width of portal vein and the degree of collateral circulation.Conclusion:There were associated with liver cirrhosis complicated with PVT and red blood cell distribution width(RDW)、 hemoglobin content 、the width of portal vein 、 the thickness of spleen and the degree of gastrointestinal bleeding and collateral circulation,what’s more,the width of portal vein and collateral circulation were the independent risk factor for the formation of PVT with liver cirrhosis.