Journal of Shandong University (Health Sciences) ›› 2018, Vol. 56 ›› Issue (12): 13-18.doi: 10.6040/j.issn.1671-7554.0.2018.183

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Risk factors of portal vein thrombosis in patients with liver cirrhosis

DING Yanfei, YANG Zhuoxin, ZHENG Wenwen, YUAN Wenjie, GAO Yanjing   

  1. Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2022-09-27

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Abstract: Objective To investigate the risk factors of portal vein thrombosis(PVT)in cirrhotic patients. Methods The clinical data of 1 670 hospitalized cirrhotic patients were retrospectively analyzed, of whom 217 with PVT were classified into the PVT group, while 250 without PVT were randomized into the non-PVT group. The general information, laboratory results, clinical manifestations, complications, surgery and drug administration history of the two groups were recorded. The risk factors of PTV were analyzed with univariate analysis and multivariate Logistic regression analysis. Results Of the 1 670 cirrhotic patients, 13% developed PVT, whose liver function was classified as Child-Pugh B and C. Univariate analysis showed significant differences in d-dimer, hemoglobin(Hb), total bilirubin(TBiL), severe esophageal varices, previous splenectomy, hemostatic drugs and propranolol between the two groups. Multivariate Logistic regression analysis showed that severe esophageal varices(OR=6.918, P=0.018), previous splenectomy(OR=4.281, P=0.007)and increase of d-dimer(OR=5.007, P<0.001)were independent risk factors of PVT. Conclusion Hemostatic drugs, propranolol, increase of d-dimer, severe esophageal varices, previous splenectomy may be associated with the formation of PVT in cirrhotic patients. Severe esophageal varices, previous splenectomy and increase of d-dimer are independent risk factors of PVT.

Key words: Liver cirrhosis, Venous thrombosis, Portal vein, Risk factors

CLC Number: 

  • R575.2
[1] Shah SL, Anderson JC, Shatzel JJ, et al. The epidemiology and clinical associations of portal vein thrombosis in hospitalized patients with cirrhosis: a nationwide analysis from the national inpatient sample[J]. J Hosp Med, 2018, 13(5):324-325.
[2] Qi X, Han G, Fan D. Management of portal vein thrombosis in liver cirrhosis[J]. Nat Rev Gastroenterol Hepatol, 2014, 11(7): 435-446.
[3] 臧立娜, 孙自勤, 刘文波, 等. 食管胃静脉曲张经内镜治疗后再出血危险因素的Meta分析[J]. 中华肝脏病杂志, 2015, 23(4): 275-280. ZANG Lina, SUN Ziqin, LIU Wenbo, et al. Meta-analysis of risk factors of gastroesophageal varices rebleeding after therapeutic endoscopy[J]. Chinese Journal of Hepatology, 2015, 23(4): 275-280.
[4] Dell'era A, Iannuzzi F, Fabris FM, et al. Impact of portal vein thrombosis on the efficacy of endoscopic variceal band ligation[J]. Dig Liver Dis, 2014, 46(2): 152-156.
[5] Qi X, Dai J, Yang M, et al. Association between portal vein thrombosis and survival in non-liver-transplant patients with liver cirrhosis: a systematic review of the literature[J]. Gastroenterol Res Pract, 2015, 2015: 480842. doi:10.1155/2015/480842.
[6] Bagheri Lankarani K, Homayon K, Motevalli D, et al. Risk factors for portal vein thrombosis in patients with cirrhosis awaiting liver transplantation in shiraz, iran[J]. Hepat Mon, 2015, 15(12): e26407. doi:10.5812/hepatmon.26407.
[7] Ghabril M, Agarwal S, Lacerda M, et al. Portal vein thrombosis is a risk factor for poor early outcomes after liver transplantation: analysis of risk factors and outcomes for portal vein thrombosis in waitlisted patients[J]. Transplantation, 2016, 100(1): 126-133.
[8] Nery F, Chevret S, Condat B, et al. Causes and consequences of portal vein thrombosis in 1,243 patients with cirrhosis: results of a longitudinal study[J]. Hepatology, 2015, 61(2): 660-667.
[9] Kinjo N, Kawanaka H, Akahoshi T, et al. Portal vein thrombosis in liver cirrhosis[J]. World J Hepatol, 2014, 6(2): 64-71.
[10] Abdel-Razik A, Mousa N, Elhelaly R, et al. De-novo portal vein thrombosis in liver cirrhosis: risk factors and correlation with the Model for End-stage Liver Disease scoring system[J]. Eur J Gastroenterol Hepatol, 2015, 27(5): 585-592.
[11] Harding DJ, Perera MT, Chen F, et al. Portal vein thrombosis in cirrhosis: Controversies and latest developments[J]. World J Gastroenterol, 2015, 21(22): 6769-6784.
[12] Francoz C, Valla D, Durand F. Portal vein thrombosis, cirrhosis, and liver transplantation[J]. J Hepatol, 2012, 57(1): 203-212.
[13] Maruyama H, Okugawa H, Takahashi M, et al. De novo portal vein thrombosis in virus-related cirrhosis: predictive factors and long-term outcomes[J]. Am J Gastroenterol, 2013, 108(4): 568-574.
[14] Violi F, Corazza GR, Caldwell SH, et al. Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry[J]. Intern Emerg Med, 2016, 11(8): 1059-1066.
[15] Francoz C, Belghiti J, Vilgrain V, et al. Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation[J]. Gut, 2005, 54(5): 691-697.
[16] Morisaka H, Motosugi U, Ichikawa T, et al. MR-based measurements of portal vein flow and liver stiffness for predicting gastroesophageal varices[J]. Magn Reson Med Sci, 2013,12(2): 77-86.
[17] Tarzamni MK, Somi MH, Farhang S, et al. Portal hemodynamics as predictors of high risk esophageal varices in cirrhotic patients[J]. World J Gastroenterol, 2008, 14(12): 1898-1902.
[18] Zocco MA, Di Stasio E, De Cristofaro R, et al. Thrombotic risk factors in patients with liver cirrhosis: correlation with MELD scoring system and portal vein thrombosis development[J]. J Hepatol, 2009, 51(4): 682-689.
[19] Ikeda M, Sekimoto M, Takiguchi S, et al. High incidence of thrombosis of the portal venous system after laparoscopic splenectomy: a prospective study with contrast-enhanced CT scan[J]. Ann Surg, 2005, 241(2): 208-216.
[20] Li MX, Zhang XF, Liu ZW, et al. Risk factors and clinical characteristics of portal vein thrombosis after splenectomy in patients with liver cirrhosis[J]. Hepatobiliary Pancreat Dis Int, 2013, 12(5): 512-519.
[21] Matsumoto T, Yamagami T, Terayama K, et al. Risk factors and clinical course of portal and/or splenic vein thrombosis after partial splenic embolization[J]. Acta Radiol, 2009, 50(6): 617-623.
[22] 李征然, 单鸿, 朱康顺, 等. 部分性脾栓塞术改变门脉血流动力学的定量研究[J]. 中华放射学杂志, 2002, 36(10): 913-917. LI Zhengran, SHAN Hong, ZHU Kangshun, et al. Clinical quantitative study of therapeutic effect of partial splenic embolization(PSE)on portal vein hemodynamics[J]. Chinese Journal of Radiology, 2002, 36(10): 913-917.
[23] Pellicelli AM, Ambrosio CD, Barbaro G, et al. Clinical and genetic factors associated to development of portal vein thrombosis in cirrhotic patients without hepatocellular carcinoma[J]. Journal of Hepatology, 2011, 54: S77. doi:10.1016/S0168-8278(11)60182-7.
[24] Zampino R, Lebano R, Coppola N, et al. The use of nonselective beta blockers is a risk factor for portal vein thrombosis in cirrhotic patients[J]. Saudi J Gastroenterol, 2018, 24(1): 25-29.
[25] Qi XS, Bai M, Fan DM. Nonselective β-blockers may induce development of portal vein thrombosis in cirrhosis[J]. World J Gastroenterol, 2014, 20(32): 11463-11466.
[26] Dai J, Qi X, Li H, et al. Role of D-dimer in the development of portal vein thrombosis in liver cirrhosis: a meta-analysis[J]. Saudi J Gastroenterol, 2015, 21(3): 165-174.
[27] de Franchis R, Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension[J]. J Hepatol, 2015, 63(3): 743-752.
[28] 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会内镜学分会, 等. 肝硬化门静脉高压食管胃静脉曲张出血防治指南(2015)[J]. 中华胃肠内镜电子杂志, 2015, 2(4): 1-21.
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