摘要
目的分析基于肝静脉压力梯度(HVPG)测定的代偿期肝硬化患者HVPG与临床常见指标的相关性及发生临床显著性门静脉高压(CSPH)的相关危险因素。方法前瞻性入组2021年4月至2021年8月在浙江树人大学附属树兰(杭州)医院感染科住院的代偿期肝硬化患者82例, 收集患者基本资料, 实验室检验结果, 肝硬度测定, 胃镜检查等, 并完成HVPG测定, 通过Pearson相关性分析、logistic单因素与多因素回归分析患者发生CSPH的相关危险因素。结果 82例入组患者, HVPG的中位值是9.0(8.3)mmHg, 有31例(27.8%)发生CSPH, 相关性分析发现CSPH与总胆红素、国际标准化比值(INR)、肝硬度呈正相关, 而与白蛋白、血红蛋白、血小板计数呈负相关。经logistic单因素回归分析显示, 影响CSPH的因素包括男性、糖尿病、食管胃底静脉曲张、白蛋白、血红蛋白、INR、血钠、白细胞、血小板计数、肝硬度及CTP、FIB-4、ALBI等。再经多因素校正, 只有血小板计数、肝硬度、食管胃底静脉曲张是代偿期肝硬化患者发生CSPH的独立危险因素。结论 HVPG是评估肝硬化门静脉高压的金标准, 血小板计数、肝硬度、食管胃底静脉曲张是代偿期肝硬化患者发生CSPH的独立危险因素, 有助于评估门静脉高压, 及早干预, 改善预后。
Objective The aim of the study is to investigate correlation between HVPG and other clinical parameters and risk factors of clinically significant portal hypertension(CSPH)in patients with compensated cirrhosis based on hepatic vein pressure gradient(HVPG).Methods 82 patients with compensated cirrhosis were prospectively recruited in the Department of Infectious Diseases of Shulan Hospital from April 2021 to August 2021.Collected the basic data of each patients,laboratory examination results,liver stiffness,gastroscopy,and HVPG.Pearson correlation analysis,univariate logistic regression analysis and multivariate regression analysis are used to find the risk factors of patients with CSPH.Results The median HVPG of 82 patients were 9.0(8.3)mmHg.There are 31 cases(27.8%)have developed CSPH,and the correlation analysis shown that CSPH was positively correlated with total bilirubin,INR and liver stiffness,but negatively correlated with albumin,hemoglobin and platelet count.According to univariate logistic regression analysis,the factors which can affecting CSPH include male,diabetes,esophageal gastric varices,albumin,hemoglobin,INR,blood sodium,white blood cells,platelet count,liver stiffness and CTP,FIB-4,ALBI,etc.After adjusted by multivariate analysis,only platelet counts,liver stiffness,esophageal gastric varices were independent risk factors for CSPH in patients with compensated cirrhosis.Conclusion HVPG is the gold criteria for assessment of portal hypertension.The platelet count,liver stiffness,esophageal gastric varices are independently associated with the development of CSPH in patients with compensated cirrhosis,which can help assess PH and give early diagnosis and treatment to improve their prognosis.
作者
蒋帆荣
颜华东
Jiang Fanrong;Yan Huadong(Department of Pharmacy,Hwamei Hospital,University of Chinese Academy of Sciences,Ningbo 315010,China;Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province,Hwamei Hospital,University of Chinese Academy of Sciences,Ningbo 315010,China;Ningbo Institute of Life and Health Industry,University of Chinese Academy of Sciences,Ningbo 315010,China;Department of Infectious Disease,Shulan,Hangzhou,Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College,Hangzhou 310004,China)
出处
《中华肝脏病杂志》
CSCD
北大核心
2021年第10期995-1000,共6页
Chinese Journal of Hepatology
基金
国家自然科学基金(81790634)
浙江省自然科学基金基础公益项目(LGF20H030006)。
关键词
门静脉高压
肝静脉压力梯度
代偿期肝硬化
Portal hypertension
Hepatic venous pressure gradient
Compensated cirrhosis
