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肝硬化门静脉高压患者肝静脉压力梯度的影响因素分析
Influencing factors for hepatic venous pressure gradient in patients with cirrhotic portal hypertension
文章发布日期:2019年09月05日  来源:  作者:周 昊,姚 欣,汤善宏,等  点击次数:135次  下载次数:21次

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【摘要】: 目的 探讨行经颈静脉肝内门体静脉分流术(TIPS)治疗的肝硬化门静脉高压患者肝静脉压力梯度(HVPG)的临床影响因素。 方法 选取2015年1月-2018年12月在中国人民解放军西部战区总医院接受TIPS治疗的肝硬化门静脉高压患者158例。在TIPS过程中,分别测量肝静脉楔压、肝静脉自由压及门静脉压,计算得出HVPG与门静脉压力梯度(PVPG)。计量资料2组间比较采用t检验,多组间比较采用单因素方差分析,进一步两两比较采用LSD-t检验。HVPG与PVPG相关性采用Pearson相关分析,采用多元线性逐步回归法分析影响HVPG的独立危险因素。 结果 HVPG与PVPG呈正相关(r=0.796,P<0.001)。单因素方差分析显示年龄、病因是HVPG的影响因素(F值分别为19.900、10.287,P值均<0.001)。多元线性逐步回归分析显示,年龄及病因是HVPG的独立影响因素(t值分别为7.870、-2.178,P值均<0.001)。结论 肝硬化门静脉高压患者的年龄和病因是HVPG的独立影响因素,年龄≥60岁或慢性丙型肝炎肝硬化门静脉高压患者具有更高的HVPG。
【Abstract】: Objective To investigate the influencing factors for hepatic venous pressure gradient (HVPG) in patients with cirrhotic portal hypertension undergoing transjugular intrahepatic portosystemic shunt (TIPS). Methods A total of 158 patients with cirrhotic portal hypertension who underwent TIPS in The General Hospital of Western Theater Command of the Chinese PLA from January 2015 to December 2018 were enrolled. Wedged hepatic venous pressure (WHVP), free hepatic venous pressure (FHVP), and portal venous pressure (PVP) were measured during TIPS, and HVPG and portal venous pressure gradient (PVPG) were calculated. The t-test was used for comparison of continuous data between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The Pearson correlation coefficient was used to analyze the correlation between HVPG and PVPG, and a multivariate linear stepwise regression analysis was used to investigate the independent risk factors for HVPG. Results HVPG was positively correlated with PVPG (r=0.796, P<0.001). The one-way analysis of variance showed that age and etiology were influencing factors for HVPG (F=19.900 and 10.287, both P<0.001). The multivariate linear stepwise regression analysis showed that age and etiology were independent influencing factors for HVPG (t=7.870 and -2.178, both P<0.001). Conclusion Age and etiology are independent influencing factors for HVPG in patients with cirrhotic portal hypertension, and the patients aged ≥60 years or the patients with hepatitis C virus-related cirrhosis tend to have higher HVPG.
【关键字】:门体分流术, 经颈静脉肝内; 肝硬化; 高血压, 门静脉; 危险因素
【Key words】:portasystemic shunt, transjugular intrahepatic; liver cirrhosis; hypertension, portal; risk factors
【引证本文】:ZHOU H, YAO X, TANG SH, et al. Influencing factors for hepatic venous pressure gradient in patients with cirrhotic portal hypertension[J]. J Clin Hepatol, 2019, 35(10): 2205-2209. (in Chinese)
周昊, 姚欣, 汤善宏, 等. 肝硬化门静脉高压患者肝静脉压力梯度的影响因素分析[J]. 临床肝胆病杂志, 2019, 35(10): 2205-2209.

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