Analysis Of Risk Factors Of Portal Vein Thrombosis In Liver Cirrhosis

ObjectiveTo investigate the risk factors of PVT in patients with liver cirrhosis and provide ideas for clinical evaluation and early intervention.MethodsFrom January 2012 to December 2016,1670 inpatients diagnosed as liver cirrhosis at Qilu Hospital of Shandong University were retrospectively analyzed.All eligible patients were diagnosed as PVT with colour dopple ultrasound or computed tomography(CT)or magnetic resonance imaging(MRI).217 patients with liver cirrhosis and PVT were in PVT group,At random,250 patients with liver cirrhosis however no PVT were in non-PVT group.We collected and recorded the following data:?General information:gender,age,etiology,child-pugh classification;? Laboratory results:hemoglobin(Hb),platelet(PLT),total bilirubin(TBil),albumin(ALB),creatinine(Cr),prothrombin time(PT),international standardized ratio(INR),fibrinogen(FIB),d-dimer;?Imaging examination:distribution of thrombosis;? Clinical manifestations and complications:diarrhea,ascites,esophageal varices,hepatic encephalopathy,spontaneous bacterial peritonitis;?Surgical history:splenectomy,partial splenic embolization,endoscopic treatment(ligation,tissue adhesives injection),and other abdominal surgery;?Drug application history:Propranolol,hemostatic medicine.Data processing:In this study the statistical analysis of the whole data was by SPSS 19.0 software.Univariate analysis was performed by Chi-square test.Multivariate analysis was performed by non-conditional Logistic stepwise forward analysis,the inclusion criteria of variables were 0.05,and the exclusion criteria were 0.1.P<0.05 was considered statistically significant.Results1.General information:Differences between the two groups in age and gender were not statistically significant(P>0.05).The etiology of liver cirrhosis in both groups was dominated by viral hepatitis B and most patients were in class Child-Pugh B and C,the differences were not statistically significant(P>0.05).2.Univariate analysis:Differences between the two groups in ALB,Cr,PT,INR,FIB,PLT,HE,SBP,diarrhea,ascites,PSE,EVL,tissue adhesives injection,other abdominal surgery were not statistically significant(P>0.05).Differences between the two groups in d-dimer,Hb,TBil,severe esophageal varices,previous splenectomy,hemostatic drugs and propranolol were statistically significant(P<0.05).3.Multivariate analysis:The statistically significant variables of the two groups were analyzed by non-conditional Logistic regressionanalysis.The results showed that severe esophageal varices(OR=3.384,P=0.009),previous splenectomy(OR=3.126,P=0.041)and increase of d-dimer(OR=5.007,P<0.001)were independent risk factors for PVT.ConclusionsHemostatic drugs,Propranolol,increase of d-dimer,severe esophageal varices,previous splenectomy may be associated with the formation of PVT in liver cirrhosis.Severe esophageal varices,previous splenectomy and increase of d-dimer are independent risk factors for PVT in liver cirrhosis.