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Prevalence and Clinical Significance of Portal Vein Thrombosis in Patients With Cirrhosis and Acute Decompensation.
Zhang, Yan; Xu, Bao-Yan; Wang, Xian-Bo; Zheng, Xin; Huang, Yan; Chen, Jinjun; Meng, Zhong-Ji; Gao, Yan-Hang; Qian, Zhi-Ping; Liu, Feng; Lu, Xiao-Bo; Shi, Yu; Shang, Jia; Li, Hai; Wang, Shao-Yang; Yin, Shan; Sun, Shu-Ning; Hou, Yi-Xin; Xiong, Yan; Chen, Jun; Li, Bei-Ling; Lei, Qing; Gao, Na; Ji, Liu-Juan; Li, Jing; Jie, Fang-Rong; Zhao, Rui-Hong; Liu, Jun-Ping; Lin, Tao-Fa; Chen, Liu-Ying; Tan, Wen-Ting; Zhang, Qun; Zou, Cong-Cong; Huang, Ze-Bing; Jiang, Xiu-Hua; Luo, Sen; Liu, Chun-Yan; Zhang, Yu-Yi; Li, Tao; Ren, Hao-Tang; Wang, Shi-Jin; Deng, Guo-Hong; Xiong, Shu-E; Liu, Xiao-Xiao; Wang, Chen; Yuan, Wei; Gu, Wen-Yi; Qiao, Liang; Wang, Tong-Yu; Wu, Dan-Dan.
Afiliação
  • Zhang Y; Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China.
  • Xu BY; Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
  • Wang XB; Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
  • Zheng X; Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China.
  • Huang Y; Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Hunan, China.
  • Chen J; Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
  • Meng ZJ; Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, Hubei, China.
  • Gao YH; Department of Hepatology, The First Hospital of Jilin University, Jilin, China.
  • Qian ZP; Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China.
  • Liu F; Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, China.
  • Lu XB; Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.
  • Shi Y; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Shang J; Department of Infectious Diseases, Henan Provincial People's Hospital, Henan, China.
  • Li H; Department of Infectious Diseases, Affiliated Hospital of Logistics University of People's Armed Police Force, Tianjin, China.
  • Wang SY; Department of Infectious Diseases, Fuzhou General Hospital of Nanjing Military Command, Fujian, China.
  • Yin S; Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China.
  • Sun SN; Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
  • Hou YX; Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
  • Xiong Y; Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China.
  • Chen J; Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Hunan, China.
  • Li BL; Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
  • Lei Q; Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, Hubei, China.
  • Gao N; Department of Hepatology, The First Hospital of Jilin University, Jilin, China.
  • Ji LJ; Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China.
  • Li J; Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, China.
  • Jie FR; Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.
  • Zhao RH; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Liu JP; Department of Infectious Diseases, Henan Provincial People's Hospital, Henan, China.
  • Lin TF; Department of Infectious Diseases, Fuzhou General Hospital of Nanjing Military Command, Fujian, China.
  • Chen LY; Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China.
  • Tan WT; Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
  • Zhang Q; Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
  • Zou CC; Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China.
  • Huang ZB; Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Hunan, China.
  • Jiang XH; Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
  • Luo S; Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, Hubei, China.
  • Liu CY; Department of Hepatology, The First Hospital of Jilin University, Jilin, China.
  • Zhang YY; Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China.
  • Li T; Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, China.
  • Ren HT; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Wang SJ; Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China.
  • Deng GH; Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
  • Xiong SE; Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China.
  • Liu XX; Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Hunan, China.
  • Wang C; Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, Hubei, China.
  • Yuan W; Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China.
  • Gu WY; Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China.
  • Qiao L; Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China.
  • Wang TY; Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China.
  • Wu DD; Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Chinese Ministry of Health (Shanghai Jiao Tong University), Shanghai, China.
Clin Gastroenterol Hepatol ; 18(11): 2564-2572.e1, 2020 10.
Article em En | MEDLINE | ID: mdl-32109631
ABSTRACT
BACKGROUND &

AIMS:

Portal vein thrombosis (PVT) is a common and serious complication in patients with cirrhosis. However, little is known about PVT in patients with cirrhosis and acute decompensation (AD). We investigated the prevalence and clinical significance of PVT in nonmalignant patients with cirrhosis and AD.

METHODS:

We performed a retrospective study of 2 cohorts of patients with acute exacerbation of chronic liver disease who participated in the Chinese AcuTe on CHronic LIver FailurE study, established by the Chinese Chronic Liver Failure Consortium, from January 2015 through December 2016 (n = 2600 patients) and July 2018 through January 2019 (n = 1370 patients). We analyzed data on the prevalence, clinical manifestations, and risk factors of PVT from 2826 patients with cirrhosis, with and without AD.

RESULTS:

The prevalence of PVT in patients with cirrhosis and AD was 9.36%, which was significantly higher than in patients with cirrhosis without AD (5.24%) (P = .04). Among patients with cirrhosis and AD, 63.37% developed PVT recently (the first detected PVT with no indication of chronic PVT). Compared with patients without PVT, a significantly higher proportion of patients with PVT had variceal bleeding (47.33% vs 19.63%; P < .001) and patients with PVT had a significantly higher median serum level of D-dimer (2.07 vs 1.25; P < .001). Splenectomy and endoscopic sclerotherapy were independent risk factors for PVT in patients with cirrhosis and AD. The 1-year mortality rate did not differ significantly between patients with vs without PVT.

CONCLUSIONS:

In an analysis of data from 2826 patients with cirrhosis, a significantly higher proportion of those with AD had PVT than those without AD. PVT was associated with increased variceal bleeding, which would increase the risk for AD. Strategies are needed to prevent PVT in patients with cirrhosis, through regular screening, to reduce portal hypertension. ClinicalTrials.gov no NCT02457637 and NCT03641872.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Varizes Esofágicas e Gástricas / Trombose Venosa Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Varizes Esofágicas e Gástricas / Trombose Venosa Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article