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Clinical characteristics of portal vein thrombosis in cirrhotic patients with variceal hemorrhage
Received:March 21, 2023  Revised:May 08, 2023  Click here to download the full text
Citation of this paper:XUE Chun-yan,RAO Chen-yi,WU Ling,HUANG Xiao-quan,CHEN Shi-yao,LI Feng.Clinical characteristics of portal vein thrombosis in cirrhotic patients with variceal hemorrhage[J].Chinese Journal of Clinical Medicine,2023,30(3):454-459
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Author NameAffiliationE-mail
XUE Chun-yan Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
RAO Chen-yi Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
WU Ling Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
HUANG Xiao-quan Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
CHEN Shi-yao Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
LI Feng Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China li.feng2@zs-hospital.sh.cn 
Abstract:Objective To evaluate the prevalence and clinical characteristics of portal vein thrombosis (PVT) in cirrhotic patients with gastroesophageal variceal bleeding (GVB). Methods The clinical data of the cirrhotic patients with GVB admitted in Zhongshan Hospital, Fudan University from 2015 to 2017 were retrospectively analyzed. The enrolled patients were divided into PVT and non-PVT groups according to the CT examination results of portal vein system. The clinical indices, such as laboratory findings, hepatic vein pressure gradient (HVPG), and endoscopic features, were compared between the two groups. The multivariate logistic regression analysis was used to evaluate the factors associated with PVT. Results Three hundred and fifty-six patients were enrolled, and 117 (32.9%) had PVT. Compared to non-PVT group, patients in the PVT group had higher previous splenectomy rate, counts of white blood cells and platelets, D-dimer level, and lower hemoglobin level (P<0.05), and higher rates of severe esophageal varices and esophageal varices with red sign (P<0.05). There was no significant difference in HVPG between the two groups. The multivariate logistic analysis showed that white blood cell count increasing, D-dimer level elevating, and severe esophageal varices were independently associated with PVT (P<0.05). Conclusions The cirrhotic patients with GVB had a high PVT rate, and these patients with PVT had more severe inflammation and procoagulant reaction accompanied by more severe portal hypertension.
keywords:liver cirrhosis  gastroesophageal variceal bleeding  portal vein thrombosis  portal hypertension
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