肝硬化食管胃底静脉曲张患者门静脉血栓形成的危险因素分析

Analysis of Risk Factors for Portal Vein Thrombosis in Cirrhotic Patients with Esophagogastric Varices

摘要: 目的：探索肝硬化食管胃底静脉曲张(Esophagogastric Varices, EGV)患者门静脉血栓形成(Portal Vein Thrombosis, PVT)的相关危险因素，为EGV患者制定预防PVT的治疗方案提供理论依据及实践指导。方法：回顾性收集我院2021年1月至2023年12月因肝硬化食管胃底静脉曲张行胃镜治疗的105例患者的临床资料(一般临床资料、实验室检查、影像学检查及胃镜检查)，根据其是否确诊门静脉血栓形成分为PVT组(门静脉血栓形成组)及NPVT组(无门静脉血栓形成组)，其中PVT组18例，NPVT组87例，进行单因素及多因素Logistic回归分析，探索PVT形成的危险因素。结果：单因素分析中PVT组与非PVT组比较，两组PLT、TBA、D-D及是否分流差异具有统计学意义(P < 0.05)，多因素分析中PLT降低、D-D升高及伴有分流是影响肝硬化食管胃底静脉曲张患者发生PVT风险的影响因素(P < 0.05)。结论：PLT降低、D-D升高及伴有分流是肝硬化食管胃底静脉曲张患者PVT形成的独立危险因素，有必要对具有高风险的EGV患者进行门静脉血栓筛查。

Abstract: Objective: To explore the risk factors associated with Portal Vein Thrombosis (PVT) in patients with cirrhotic Esophagogastric Varices (EGV), and to provide a theoretical basis and practical guidance for developing preventive strategies against PVT in this population. Methods: A retrospective analysis was conducted on clinical data from 105 patients with cirrhotic EGV who underwent endoscopic treatment at our hospital between January 2021 and December 2023. The data included general clinical information, laboratory findings, imaging studies, and endoscopic results. Patients were divided into a PVT group (Portal Vein Thrombosis group, n = 18) and a NPVT group (Non-Portal Vein Thrombosis group, n = 87) based on confirmed PVT diagnosis. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for PVT. Results: Univariate analysis showed significant differences between the PVT and non-PVT groups in PLT, TBA, D-D, and presence of shunts (P < 0.05). Multivariate analysis identified decreased PLT, elevated D-D, and presence of shunts as independent risk factors for PVT in patients with cirrhotic EGV (P < 0.05). Conclusion: Decreased PLT, elevated D-D, and presence of shunts are independent risk factors for PVT formation in patients with cirrhotic EGV. Screening for PVT is warranted in high-risk EGV patients.