Analysis Of Clinical Features And Risk Factors For Portal Vein Thrombosis In Cirrhotic Patients

ObjectiveThe purpose of this study is to analyze the clinical features andrisk factors for portal vein thrombosis in cirrhotic patients,providing clinical basis for the prevention and early detection ofportal vein thrombosis in cirrhotic patients.MethodsWe performed a retrospective analysis of79cirrhotic patientsdiagonosed in the First Hospital of Jilin University from January2013to December2013.MSCT or color doppler ultrasound were used todiagnose PVT. We divided patients into two groups,25cirrhoticpatients with PVT was thrombosis group and54cirrhotic patientswithout PVT was control group. We collected the clinical informationsof each patient.The diameter of main portal vein and splenic portalvein,the thickness of spleen,the longth of spleen,the site ofthrombosis and ascites were measured by color doppler ultrasound.SPSS20.0software was used in statistic analysis.ResultsThrombus in MPV was the most common,which accout80.00%(20/25).Study on age,gender,white blood cell,hemoglobin,platelet,thrombin time,prothrombin time,activated partial prothrombin time,prothrombinactivity,international normalized ratio,prothrombin time ratio,fibrinogen,aspartate aminotransferase,alanine aminotransferase,γ-glutamyl transpeptadase,alkaline phosphatase,total bilirubin,direct bilirubin,indirect bilirubin,total protein,albumin,cholinesterase, Child-Pugh score,α-fetoprotein,urea nitrogen, serumcreatinine,glucose,total cholesterol,Na,K,Ca,Cl with similar results,there were no significant statistical difference between thrombusgroup and control group(p>0.05).But there was a broader main portalvein（16.443.75vs11.711.57，p=0.000）,a thicker splenic-thickness（57.4511.72vs46.789.34，p=0.001）,a longer longth of spleen（139.5513.10vs127.6129.87, p=0.022）,a broader splenic portalvein（11.601.19vs8.471.59，p=0.000） and a bigger splenic area（8096.452111.10vs6123.752333.21，p=0.002） in thrombus group,the difference was statistically significant.Analysis of multivariateunconditonal logistic regression model indicate that MPV,FBG andsplenectomy were single harzard factors of PVT in cirrhoticpatients(p=0.000，0.025，0.013；OR：3.250，9.823，32.502).The risk ofthe formation of PVT would increase3.250times with increasing oneunit of the diameter of MPV,and9.823times with increasing one unitof FBG.The cirrhotic patients with splenectomy would have a higher riskof the formation of PVT than the patients without splenectomy,the OR value was32.502. Through the coordinates of the curve, we could getthat when the diameter of MPV was13.50mm and FBG was1.745g/l，thesensitivity and specificity of predicting the formation of PVT wouldbe good.ROC was plotted and the AUC was calculated to evaluate thediagnose performance which indicated that the diameter of MPV>FBG(AUC:0.904>0,590). Percent age of complications with uppergastrointestinal hemorrhage and massive ascites were greater thancontrol group,the difference was statitically significant (p<0.05).But the percentage of spontaneous bacterial peritonitis,chronicliver failure and hepatic encephalopathy was similiar, there were nosignificant statistical difference between thrombus group and controlgroup(p>0.05).Conclusion1. The formation of PTV in cirrhotic patients had no effect onliver’s function,but mainly increased portal pressure.2. The incidence of complications such as upper gastrointestinalhemorrhage and ascites would be increase in cirrhotic patients withPVT.3. The diameter of MPV,FBG and splenectomy were single harzardfactors of PVT in cirrhotic patients.The broader the diameter of MPVwas,the higher level of FBG was,the incidence of PVT would be higherand the patients with splenectomy would have higher risk than the patients without splenectomy.When the diameter of MPV was13.50mm andFBG was1.745g/l，the sensitivity and specificity of predicting theformation of PVT would be good.