Abstract: Objective To analyze the effect of spontaneous portosystemic shunt on the prognosis of chronic hepatitis B patients with liver cirrhosis, and to provide theoretical basis for the clinical treatment and prognostic evaluation of such patients. Methods A total of 72 patients (40 males and 32 females) with an average age of (46.3±8.7) years were enrolled in this study from January 2020 to January 2021. The measured value of portal vein pressure as represented by hepatic venous pressure gradient (HVPG) >10mmHg is defined as portal hypertension, and HVPG <10mmHg is defined as normal portal pressure. The measurement data are expressed as (±s), and compared using t-test between these two groups, while the counting data are expressed as (%) and analyzed with chi-square test. Results There were 35 patients (20 males and 15 females) with portal hypertension, with an average age of (46.0±8.9) years. There were 37 cases (20 males and 17 females) with normal portal vein pressure, with an average age of (46.6±8.4) years. The levels of ALB, ALT, AST, TBIL, PT and PLT in the hypertension group were (23.5±4.3)g/L, (223.2±21.6)U/L, (189.6±30.9)U/L, (78.2±9.3) μmol/L, (18.3±4.3)s and (61.39.3)×10⁹/L, respectively. Compared with those of [(32.0±5.6) g/L, (51.7±11.4) U/L, (45.8±22.3) U/L, (52.1±6.1) μmol/L, (11.9±3.9) s and (95.9±9.6)×10⁹/L] in the normal group, respectively, and the differences were statistically significant (t=10.142, -56.358, 37.445, -11.208, -17.569, 12.120, P<0.05). The internal diameters of portal vein in hypertension group and normal group were (12.3±2.3)cm and (14.6±3.0)cm, respectively, the difference was statistically significant (t=9.126, P<0.05). The depth of ascites in high pressure group and normal group was (79.6±12.3) cm and (53.2±9.6)cm, respectively, and the difference was statistically significant (t=-11.269, P<0.05). There were 14 cases (40.0%) in high pressure group and 1 case (3.1%) in normal pressure group developed gastrointestinal bleeding, with statistical significant difference (χ²=-68.104, P<0.05). Hepatic encephalopathy occurred in 17 cases (48.6%) of high pressure group and 1 case (3.1%) in normal pressure group, and the difference was statistically significant (χ²=-78.345, P<0.05). Ten patients (28.6%) died in high pressure group, which was statistically significant when compared to that of two patients (5.4%) in the normal pressure group (χ²=-30.504, P<0.05). The levels of PCⅢ, IV-C, LN and HA in the hypertension group were (42.1±11.1) ng/mL, (192.2±18.6) ng/mL, (156.0±14.5) ng/mL and (285.3±23.9) ng/mL, respectively, which were significantly higher than those of [(21.8±9.7) ng/mL, (143.9±10.6) ng/mL, (131.2±15.2) ng/mL and (176.9±22.3) ng/mL in the normal pressure group, respectively [t=-16.800, -11.602, -9.786, -13.612, P<0.05]. Conclusion Liver cirrhosis in chronic hepatitis B patients leads to increased portal pressure and compensatory spontaneous portosystemic shunt that may further deteriorate liver function, aggravate liver cirrhosis progression, cause gastrointestinal bleeding and hepatic encephalopathy, and impose adverse effect on the prognosis of patients.

Key words: Spontaneous portosystemic shunt, Cirrhosis after hepatitis B, Portal hypertension, Hepatic encephalopathy, Gastrointestinal bleeding