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目的探讨不同严重程度门静脉血栓(PVT)肝硬化患者的肝功能及门静脉高压并发症的临床特点,明确PVT的临床意义。方法回顾性收集2014年1月-2015年6月首都医科大学附属北京佑安医院收治的肝硬化合并PVT患者178例,根据血栓严重程度分为单支血栓组(n=109)和多支血栓组(n=69)。记录患者的病因、临床表现、实验室结果及胃镜检查结果。符合正态分布的计量资料组间比较采用t检验,不符合正态分布的计量资料组间比较采用Wilcoxon秩和检验,计数资料组间比较采用χ~2检验。结果单支血栓组中乙型肝炎肝硬化患者比例明显低于多支血栓组(50.5%vs 71.0%,χ~2=7.350,P=0.008),单支血栓组自身免疫性肝硬化比例明显高于多支血栓组(11.0%vs 0,χ~2=8.145,P=0.004);单支血栓组的PTA水平低于多支血栓组[(63.58±21.12)%vs(71.84±16.68)%,t=-2.701,P=0.008];单支血栓组食管静脉曲张重度比例显著低于多支血栓组(57.7%vs81.1%,χ~2=8.921,P=0.012);单支血栓组食管静脉曲张红色征阳性比例明显低于多支血栓组(64.1%vs 86.8%,χ~2=8.298,P=0.005)。结论门静脉多支血栓并未影响患者的肝功能,门静脉多支血栓患者较单支血栓患者食管静脉曲张更加显著。
Objective To investigate the clinical features of liver function and portal hypertension in patients with portal vein thrombosis (PVT) of different severity and to determine the clinical significance of PVT. Methods One hundred and eighty-eight patients with cirrhosis and PVT admitted from Beijing You’an Hospital Affiliated to Capital Medical University from January 2014 to June 2015 were retrospectively studied. According to the severity of thrombosis, they were divided into single thrombosis group (n = 109) and multiple thrombosis Group (n = 69). Record the patient’s etiology, clinical manifestations, laboratory results and endoscopy findings. The t test was used to compare the metrological data with normal distribution, and the Wilcoxon rank sum test was used to compare the metrological data that did not fit the normal distribution. The data between groups were compared byχ ~ 2 test. Results The proportion of patients with hepatitis B cirrhosis in the single thrombosis group was significantly lower than that in the multiple thrombosis group (50.5% vs 71.0%, χ ~ 2 = 7.350, P = 0.008). The proportion of autoimmune cirrhosis in the single thrombosis group was significantly higher (P <0.01). The PTA level in single thrombosis group was significantly lower than that in multi thrombosis group (11.5% vs 0, χ ~ 2 = 8.145, P = 0.004) t = -2.701, P = 0.008]. Severe esophageal varices in single thrombosis group were significantly lower than those in multi thrombosis group (57.7% vs81.1%, χ ~ 2 = 8.921, P = 0.012) The positive rate of varicose red sign was significantly lower than that of multi-thrombus group (64.1% vs 86.8%, χ ~ 2 = 8.298, P = 0.005). Conclusions Multi-vessel thrombosis of portal vein did not affect the liver function of patients. Multi-vessel thrombosis of portal vein was more significant than esophageal varices of single-vessel thrombosis.