Analysis Of Influencing Factors Of HVPG Based On TIPS In The Treatment Of Patients With Liver Cirrhosis And Portal Hypertension

Objective:To explore the hepatic venous pressure gradient(HVPG)of patients with liver cirrhosis,portal hypertension,ruptured esophageal and gastric varices,or refractory ascites by transjugular intrahepatic portosystemic shunt(TIPS)related influencing factors.Methods:This article selects patients who underwent TIPS treatment due to rupture of esophageal and gastric varices or refractory ascites at the Department of Interventional Vascular Surgery of Hunan Provincial People’s Hospital from January 1,2020 to October 1,2020,and collected relevant clinical data and analyzed them.Influencing factors related to HVPG;t-test was used for comparison of measurement data between two groups,single-factor analysis of variance was used for comparison between multiple groups,and LSD-t test or Dunnett T3 test was used for further pairwise comparison.Pearson correlation analysis was used for the correlation between HVPG and portal venous pressure gradient(PVPG).The statistically significant results of univariate analysis were further analyzed by multiple linear stepwise regression analysis to obtain independent influencing factors of HVPG,in order to provide patients with high-risk factors with better surgical options and intervention time judgments,and reduce patient repetition.The risk of massive gastroin testinal bleeding improves the prognosis of patients with portal hype rtension.Results:Among the 50 patients who met the criteria for discharge,the average value of PVPG was(25.24±3.26)mm Hg and the average value of HVPG was(24.59 ± 3.62)mm Hg.There was a positive correlation between HVPG and PVPG(r=0.718,P<0.001).Causes of liver cirrhosis(F=4.90,P=0.005),age(F=8.06,P < 0.001),number of bleeding(F=23.56,P < 0.001),ascites(F=9.04,P < 0.001),portal thrombosis(T=-2.05,P=0.045)is related to HVPG.Further multi-factor analysis showed that age,bleeding times,and chronic hepatitis C cirrhosis in the etiology are independent influencing factors of HVPG(R=0.858,R2=0.737),The adjusted coefficient of determination=0.717,F=37.335,P< 0.001).Gender(t=0.16,P=0.878),virus replication rate(t=-0.165,P=0.880),underlying disease(F=0.86,P=0.492),esophageal varices(F=2.13,P=0.142),Gastric fundus varicose(F=0.29,P=0.758),ChildPugh score(F=0.66,P=0.524),Meld score(F=0.49,P=0.611),ALBI score(F=0.23,P=0.795),APRI score(t=0.54,P=0.594)has no significant effect on HVPG.Conclusion:1.HVPG is related to the patient’s age,cause of liver cirrhosis,number of bleeding,thrombosis,and ascites,and age,cause of liver cirrhosis,and number of bleeding are independent influencing factors of HVPG;while the patient ’ s gender,virus replication rate,underlying disease,esophageal varices There is no significant correlation between gastric fundus varicose veins,Child-Pugh score,Meld score,ALBI score,APRI score and HVPG.2.The HVPG may be higher in patients with age≥60 years,chronic hepatitis C cirrhosis,and patients with multiple bleeding in the past.3.There is a good correlation between HVPG and PVPG.