Risk factors for portal vein thrombosis in cirrhotic patients and the influences of anticoagulation on esophagogastric variceal bleeding
10.3760/cma.j.issn.1008-1372.2019.12.013
- VernacularTitle: 肝硬化者并门静脉血栓形成的危险因素及抗凝治疗对其上消化道出血的影响
- Author:
Yanjie CHEN
1
;
Xinyu WAN
;
Yuan LI
;
Jian WANG
;
Nonghua LYU
Author Information
1. Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
- Publication Type:Journal Article
- Keywords:
Liver cirrhosis;
Venous thrombosis;
Portal vein;
Anticoagulants;
Gastrointestinal hemorrhage
- From:
Journal of Chinese Physician
2019;21(12):1808-1812,1816
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the associated factors and the independent risk factors for portal vein thrombosis (PVT) in cirrhotic patients and assess the influences of anticoagulation on esophagogastric variceal bleeding (EGVB) in these patients.
Methods:From January 2012 to December 2012, 239 cirrhotic patients were diagnosed in our hospital. According to the presence or absence of portal vein thrombosis (PVT), they were divided into thrombus group (33 cases) and control group (206 cases). According to the presence or absence of EGVB in thrombus group, they were divided into bleeding group (10 cases) and non bleeding group (23 cases). According to whether anticoagulant therapy was used in thrombus group, they were divided into anticoagulant group (10 cases) and non anticoagulant group (23 cases). The risk factors of each group and its control group were observed and compared.
Results:The thrombus group had a lower level of the albumin (ALB) , higher level of count of platelet (PLT), diameter of main portal vein (MPV), propotion of diabetes prevalence and history of splenectomy compared with the control group (P<0.01). According to unconditional logistic regression analysis, both the PLT and the diameter of MPV were identified as independent risk factors for PVT in cirrhotic patients (P=0.009, 0.001; OR=1.006, 16.858). There were significant differences in the degree of varicose veins and the proportion of sequential endoscopic treatment between the bleeding group and the control group (P<0.05). Moreover, the group treated with anticoagulant drugs and the group without anticoagulation were followed up and observed for 1 year, which showed no significant changes in the bleeding ratio between two groups [40% (4/10) versus 26.1% (6/23), P>0.05].
Conclusions:⑴ PLT, ALB, MPV, and a history of diabetes or splenectomy are risk factors for cirrhosis combined with PVT, and PLT and MPV are independent risk factors. ⑵ The incidence of EGVB increased with the increasing severity of esophagogastric varicose vein. The endoscopic variceal sequential treatment can contribute a significant reduction of EGVB in cirrhosis complicated by PVT. ⑶ Anticoagulant therapy may not raise the incidence of EGVB in cirrhotic patients with PVT.
