摘要
目的探讨肝硬化门静脉血栓(PVT)形成的危险因素。方法计算机检索中国知网、万方、维普、CBM、PubMed、Scopus以及Web of Science等数据库,对肝硬化PVT相关危险因素文章进行查阅及合并分析,检索时间截至2023年8月,使用纽卡斯尔-渥太华量表(NOS)进行质量评价,采用Stata 15.1软件进行Meta分析,当P<0.05时,认为结果具有统计学意义。结果共纳入17篇病例对照研究,2 749例病例,血栓组838例,非血栓组1 911例,Meta分析结果提示,D-二聚体[SMD=1.12, 95%CI(0.76-1.48)]、门静脉直径[SMD=0.72, 95%CI(0.47-0.96)]、门静脉血流速度[SMD=-1.03, 95%CI(-1.60--0.47)]和脾脏厚度[SMD=0.94, 95%CI(0.52-1.35)]与肝硬化并发PVT有关,结果具有统计学意义。而血小板计数、凝血酶原时间、活化部分凝血酶原时间、纤维蛋白原和总胆红素水平等指标与肝硬化并发PVT无关。敏感性分析结果提示结果稳定,漏斗图提示结果存在一定的发表偏倚。结论肝硬化患者D-二聚体、门静脉直径、门静脉血流速度和脾脏厚度为并发PVT的危险因素。
Objective To investigate the risk factors of portal vein thrombosis (PVT) in liver cirrhosis.Methods A computer search was conducted on CNKI, Wanfang, Vipp, CBM, PubMed, Scopus, Web of Science and other databases to review and combine the articles on risk factors related to liver cirrhosis PVT. The search time was up to August 2023, and the Newcastle-Ottawa Scale (NOS) was used for quality evaluation. Stata 15.1 software was used for meta-analysis, and the results were considered statistically significant when P<0.05.Results A total of 17 case-control studies were included, including 2 749 cases, 838 cases in the thrombus group and 1 911 cases in the non-thrombus group. The results of meta-analysis suggested that D-dimer [SMD = 1.12, 95% CI (0.76-1.48)], the diameter of portal vein, [SMD = 0.72, 95% CI (0.47-0.96)], portal blood flow velocity [SMD = 1.03, 95%CI(-1.60--0.47)] and spleen thickness [SMD = 0.94, 95%CI (0.52 - 1.35)] were associated with cirrhosis complicated with PVT, and the results were statistically significant. However, platelet count, prothrombin time, activated partial prothrombin time, fibrinogen and total bilirubin levels were not associated with PVT in cirrhosis. The results of sensitivity analysis suggested that the results were stable, and the funnel plot suggested that there was some publication bias.Conclusion D-dimer, portal vein diameter, portal vein flow velocity and spleen thickness were risk factors for PVT in cirrhotic patients.
作者
莫闲
杨闯
Xian Mo;Chuang Yang(Sichuan North Medical College,Nanchong Sichuan Province 637000,China;Department of Hepatobiliary and Pancreatic Surgery,Sichuan Mental Health Centre-Mianyang Third People's Hospital,Mianyang Sichuan Province 621000,China)
出处
《中华普外科手术学杂志（电子版）》
2023年第6期678-683,共6页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
肝硬化
门静脉血栓
危险因素
META分析
Liver Cirrhosis
Portal Vein Thrombosis
Risk Factors
Meta-Analysis
