Impact of portal vein thrombosis on prognosis of patients with liver cirrhosis

• Main Authors: TANG Wen, WANG Yu, ZHAO Xinyan
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2017-03-01
• Series: Linchuang Gandanbing Zazhi
• Subjects: liver cirrhosis; venous thromboembolism; prognosis
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=8063
• ISSN: 1001-5256; 1001-5256

ObjectiveTo investigate the impact of portal vein thrombosis (PVT), a common complication of liver cirrhosis, on the prognosis of patients with liver cirrhosis via a prospective cohort study. MethodsThe patients who were diagnosed with liver cirrhosis and hospitalized in Liver Research Center, Beijing Friendship Hospital, from June 2013 to June 2014 were enrolled. According to the presence or absence of PVT, they were divided into PVT group(22 patients) and non-PVT group(92 patients). The patients were followed up regularly, and outcome events included variceal bleeding, refractory ascites, hepatic encephalopathy, and liver disease-related death. The independent samples t-test was used for comparison of normally distributed continuous data between groups, the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups, and the chi-square test and Fisher’s exact test were used for comparison of categorical data. Univariate and multivariate Cox regression analyses were used to determine risk factors. ResultsCompared with the non-PVT group, the PVT group had significantly higher cumulative incidence rates of decompensation event (χ2=7.539, P=0006), variceal rupture and bleeding (χ2=5.390, P=002), and intractable ascites (χ2=19.360, P＜0.001), while there was no significant difference in the cumulative incidence rate of hepatic encephalopathy between the two groups (χ2=2.006, P=0.157). PVT was an independent risk factor for decompensation event (HR=12.907, 95%CI： 2.537-65.658, P=0.002) and intractable ascites (HR=27055, 95%CI：3.191-229.414, P=0.002). The PVT group had a lower cumulative survival rate than the non-PVT group (χ2=7112, P=0.008), while after the patients were stratified according to Child-Pugh class, there was no significant difference in cumulative survival rate between the two groups for patients with a Child-Pugh score of ≥10 (χ2=2.066, P=0.151) or the patients with Child-Pugh score of ＜10(χ2=3.068, P=0.08). ConclusionPVT is an independent risk factor for decompensation event and refractory ascites in patients with liver cirrhosis, but it is not an independent risk factor for death in patients with liver cirrhosis.