首页|肝硬化患者肝内静脉分流的危险因素及其对肝静脉压力梯度的影响

肝硬化患者肝内静脉分流的危险因素及其对肝静脉压力梯度的影响

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目的 评估肝硬化患者发生肝内静脉分流(IVVS)的影响因素及其对肝静脉压力梯度(HVPG)的影响.方法 回顾性分析2013年4月至2022年3月在南京鼓楼医院接受HVPG测定的肝硬化患者资料,采用单因素及多因素回归分析的方法,研究IVVS发生率和其危险因素,以及其对HVPG的影响.计量资料数据比较采用t检验、秩和检验,计数资料数据比较采用x2检验.结果 共有242例肝硬化患者纳入统计学分析,其中有IVVS者54例(22.3%),无IVVS者188例(77.7%).两组患者基线资料中凝血酶原时间(PT)、HVPG和脾切除史的差异有统计学意义(P值均<0.05).多因素logistic回归分析的结果显示PT是IVVS发生的独立危险因素(P<0.05),合并IVVS的患者HVPG数值偏低[(17.58±5.57)mmHg与(11.92±5.38)mmHg,1 mmHg=0.133 kPa;t=6.623,P<0.001].结论 肝硬化患者具有较高的IVVS发生率,其与偏短的凝血酶原时间密切相关,合并IVVS的患者HVPG数值偏低,影响其准确性.
Risk factors for intrahepatic venovenous shunt in patients with cirrhosis and its impact on hepatic venous pressure gradient
Objective To evaluate the factors affecting the incidence of intrahepatic venovenous shunt(IVVS)in patients with cirrhosis and its impact on hepatic venous pressure gradient(HVPG).Methods A retrospective analysis was performed on the data of patients with liver cirrhosis who received HVPG measurement in Nanjing Drum Tower Hospital from April 2013 to March 2022.Univariate and multivariate regression analyses were used to investigate the incidence rate and risk factors of IVVS and its impact on HVPG.The t-test and rank-sum test were used for the measurement data,and the x2 test was used for the count data.Results A total of 242 cases with cirrhosis were included in the statistical analysis,including 54(22.3%)with IVVS and 188(77.7%)without IVVS.There was a statistically significant difference(P<0.05)in prothrombin time(PT),HVPG,and splenectomy history between the two groups of patients'baseline data(all P<0.05).The multiple logistic regression analysis results showed that PT was an independent risk factor for the occurrence of IVVS(P<0.05),and patients combined with IVVS had lower HVPG values[(17.58±5.57)mmHg vs.(11.92±5.38)mmHg,1 mmHg=0.133 kPa;t=6.623,P<0.001].Conclusions Patients with liver cirrhosis have a high incidence rate of IVVS,which is closely associated with a low prothrombin time.Additionally,patients combined with IVVS have low HVPG values,which affect its accuracy.

Liver cirrhosisIntrahepatic veno-venous shuntHepatic venous pressure gradientProthrombin time

丁量子、蔡子豪、肖江强、张明、张峰、诸葛宇征

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南京医科大学鼓楼临床医学院,南京 210000

南京大学医学院附属鼓楼医院消化内科,南京 210000

肝硬化 肝内静脉分流 肝静脉压力梯度 凝血酶原时间

2024

中华肝脏病杂志
中华医学会

中华肝脏病杂志

CSTPCD北大核心
影响因子:1.625
ISSN:1007-3418
年,卷(期):2024.32(11)