Risk Factors Of Portal Vein Thrombosis In Patients With Liver Cirrhosis

Object To investigate the clinical risk factors of portal vein thrombosis in patients with liver cirrhosis, and analyze the risk factors influencing on the origin of PVT.Methods We performed a retrospective study of 171 cirrhotic patients who diagnosed in the Department of Hepatobiliary and Pancreatic Medicine, the Second Affiliated Hospital of Kunming Medical University between September 2013 and December 2014.CT or color Doppler ultrasound were used to diagnose PVT. Patients were divide into two groups,34 patients who diagnose PVT as experiment group, and 137 patients as control group. We collected clinical features and laboratory indexes of two groups, include sex, age, hypertension, diabetes mellitus,smoking and drinking, pathogeny of cirrhosis. Main portal vein diameter, portal vein velocity, the amount of ascites were measured by color Doppler ultrasound. Laboratory examination were blood routine examination, blood chemistries, blood coagulation function, D-dimer, antithrombin-Ⅲ, Child-Pugh, MELD score. CT displays the position of PVT.SPSS20.0 software was used in statistic analysis, t-test was used in measurement data,x2 test was used in enumeration data, and unconditional Logistic regression model(Wald test) was used to screen independent risk factors. Looking for a risk factor of predictive value for screen the risk factors of PVT by drawing ROC curve and determining the optimal threshold.Result 1.In totally 171 patients,34 cases complicated with PVT, morbidity was 19.88%.2.Thrombus in main portal vein was the most common, there were 22 cases(64.7%).3.Study on gender, age, pathogeny of cirrhosis, hypertension, diabetes mellitus, smoking and drinking, ALB、TBIL、DBIL、TG、Scr、NA、PT、INR、APTT、 FIB、AT-Ⅲ、Child-Pugh,MELD score、PLT、RBC、WBC、the amount of ascites, there were no significant statistical difference between thrombus group and control group(p>0.05). D-dimer,width of main portal vein,portal vein velocity flow,the difference were statistically significant. Analysis of unconditional Logistic regression model indicate that width of main portal vein was single risk factor of PVT in cirrhosis patients. Using receive operating characteristic curve to calculate the area under the curve is 0.669,0.742.Summary 1. Width of main portal vein is single risk factor of PVT in cirrhosis patients. After the formation of PVT aggravated portal hypertension,portal vein diameter widened. Widened portal vein in favor of thrombosis.When diameter of main portal vein wider than 1.3cm,we should take monitoring more seriously, so that we can prevent occurrence of portal vein thrombosis. T here is great relativity between PVT in liver cirrhosis with D-dimer, portal vein velocity flow.2.There is small relativity between PVT in liver cirrhosis with gender, age, pathogeny of cirrhosis, hypertension, diabetes mellitus,smoking and drinking,liver function, kidney function.3. PVT located in main portal vein more than superior mesenteric vein. Thrombosis tendency spread easily to the mesenteric vein.