Clinical significance of portal vein thrombosis in patients with HBV related decompensated liver cirrhosis

Abstract

Abstract: Objective To investigate the incidence and influencing factors of portal vein thrombosis (PVT) in patients with hepatits B virus related decompensated liver cirrhosis (HBV-DLC).Methods A total of 242 patients with HBV-DLC (164 males and 78 females) admitted to our hospital from January 2012 to June 2017 were enrolled. Among all the patients, there were 28 cases with PVT and 214 cases without PVT, and the average age was (51.6±7.6) years. Univariate analysis and multivariate analysis were performed to determine independent risk factors.Results The ages of PVT group and non-PVT group were 55 (46, 63) and 51 (43, 59) years old, and the difference was statistically significant (Z=6.004, P<0.05). There were 15 males in PVT group (53.6%) and 162 males in non-PVT group (75.7%), and the difference was statistically significant (χ²=-6.172, P<0.05). There were 14 cases (50.0%) and 38 cases (17.8%) with variceal bleeding in PVT group and non-PVT group, with statistically significant (χ²=15.258, P<0.05). There were 6 cases and 22 cases with diabetes mellitus in PVT group (21.4%) non-PVT group (10.3%), the difference was statistically significant (χ²=3.008, P<0.05). Total bilirubin, international normalized ratio (INR), D-dimer, model for end stage liver disease (MELD) score and Child-Pugh score in PVT group were 27.8 (18.0, 53.5) μmol/L, 1.4 (1.3, 1.6), 2.1 (1.0, 4.9), 12 (9, 15) points, 8 (7, 10) points, which were significantly different from those in non-PVT group [95.4(32.5, 280.8) μmol/L, 1.6(1.3, 2.0), 1.2(0.5, 2.9), 17(12, 24) points, 10(8, 11) points], (Z=-15.635, -6.006, 10.581, -9.130 and -6.384, P<0.05). There were 6 cases (21.4%) and 8 cases (3.7%) with splenectomy in PVT group non-PVT group, the difference was statistically significant (χ²=14.216, P<0.05). There were 6 cases (21.4%) and 10 cases (4.7%) with endoscopic sclerotherapy in PVT group and non-PVT group, the difference was statistically significant (P<0.05). There was no significant difference in ascites, white blood cell (WBC), drinking history, platelet (PLT), creatinine and transjugular intrahepatic portosystemic shunt (TIPS) between the 2 groups (P>0.05). Taking all influencing factors with statistical differences as independent variables and the occurrence of PVT in patients with HBV-DLC was regarded as dependent variable (0 = no PVT, 1 = PVT). The results of analysis showed that age, splenectomy and endoscopic sclerotherapy were independent risk factors for PVT in HBV-DLC patients (P<0.05).Conclusion Advanced age, splenectomy and endoscopic sclerotherapy are related to the occurrence of PVT in patients with HBV-DLC, which deserves more clinical attention.

Key words: Hepatitis B virus related decompensated liver cirrhosis, Portal vein thrombosis, Splenectomy, Endoscopic sclerotherapy

WANG Li-hui, WANG Rong-xi, ZHAO Ze-yuan, GUO Zhen-kai. Clinical significance of portal vein thrombosis in patients with HBV related decompensated liver cirrhosis[J]. Chinese Hepatolgy, 2022, 27(8): 874-876.

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