肝硬化合并门静脉血栓的研究进展

王万琴; 文茂瑶; 凡小丽; 沈怡; 杨晓雪; 杨丽

doi:10.3969/j.issn.1001-5256.2016.07.045

肝硬化合并门静脉血栓的研究进展

DOI: 10.3969/j.issn.1001-5256.2016.07.045

四川大学华西医院消化内科

基金项目:

四川省科技厅项目(2014SZ0002)；

详细信息

中图分类号: R575.2
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出版历程
- 出版日期: 2016-07-20

Research advances in liver cirrhosis complicated by portal vein thrombosis

Research funding:

摘要

摘要: 门静脉血栓(PVT)是肝硬化常见并发症之一,回顾了近几年肝硬化合并PVT的研究进展,认为PVT是多种因素共同作用的结果,血流动力学紊乱是PVT发生的重要基础,PVT的分类可根据血栓栓塞程度及受累门静脉分支分为不同种类,药物抗凝和介入治疗是目前常用的治疗手段,而PVT的发生不会加重肝硬化患者病程的进展,但可能影响肝硬化患者行肝移植术的预后。
- 肝硬化 /
- 静脉血栓形成 /
- 综述
Abstract: Portal vein thrombosis( PVT) is a common complication of liver cirrhosis. This article reviews the research advances in liver cirrhosis complicated by PVT in recent years and points out that PVT is induced by the combined effect of various factors. Hemodynamic disorder is an important basis for the development of PVT. PVT can be classified into different types according to the degree of thromboembolism and the portal vein branches involved. At present,anticoagulant therapy and interventional therapy are commonly used in the treatment of PVT. The development of PVT may not promote the progression of liver cirrhosis,but it may affect the prognosis of patients with liver cirrhosis who receive liver transplantation.
- liver cirrhosis /
- venous thrombosis /
- review

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参考文献(44)

[1]RAJA K,JACOB M,ASTHANA S.Portal vein thrombosis in cirrhosis[J].J Clin Exp Hepatol,2014,4(4):320-331.

[2]HARDING DJ,PERERA MT,CHEN F,et al.Portal vein thrombosis in cirrhosis:controversies and latest developments[J].World J Gastroenterol,2015,21(22):6769-6784.

[3]FRANCOZ C,VALLA D,DURAND F.Portal vein thrombosis,cirrhosis,and liver transplantation[J].J Hepatol,2012,57(1):203-212.

[4]CHEN H,TRILOK G,WANG F,et al.A single hospital study on portal vein thrombosis in cirrhotic patients-clinical characteristics&risk factors[J].Indian J Med Res,2014,139(2):260-266.

[5]WEBSTER GJ,BURROUGHS AK,RIORDAN SM.Review article:portal vein thrombosis-new insights into aetiology and management[J].Aliment Pharmacol Ther,2005,21(1):1-9.

[6]DELEVE LD,VALLA DC,GARCIA TG.Vascular disorders of the liver[J].Hepatology,2009,49(5):1729-1764.

[7]GAO PJ,GAO J,LI Z,et al.Liver transplantation in adults with portal vein thrombosis:data from the China Liver Transplant Registry[J].Clin Res Hepatol Gastroenterol,2016,40(3):327-332.

[8]ENGLESBE MJ,KUBUS J,MUHAMMAD W,et al.Portal vein thrombosis and survival in patients with cirrhosis[J].Liver Transpl,2010,16(1):83-90.

[9]KINJO N,KAWANAKA H,AKAHOSHI T,et al.Portal vein thrombosis in liver cirrhosis[J].World J Hepatol,2014,6(2):64-71.

[10]NERY F,CHEVRET S,CONDAT B,et al.Causes and consequences of portal vein thrombosis in 1243 patients with cirrhosis:results of a longitudinal study[J].Hepatology,2015,61(2):660-667.

[11]MARUYAMA H,OKUGAWA H,TAKAHASH M,et al.De novo portal vein thrombosis in virus-related cirrhosis:predictive factors and long-term outcomes[J].Am J Gastroenterol,2013,108(4):568-574.

[12]ZOCCO MA,DI STASIO E,DE CRISTOFARO R,et al.Thrombotic risk factors in patients with liver cirrhosis:correlation with MELD scoring system and portal vein thrombosis development[J].J Hepatol,2009,51(4):682-689.

[13]QI X,LI H,LIU X,et al.Novel insights into the development of portal vein thrombosis in cirrhosis patients[J].Expert Rev Gastroenterol Hepatol,2015,9(11):1421-1432.

[14]KAWANAKA H,AKAHOSHI T,KINJO N,et al.Impact of antithrombinⅢconcentrates on portal vein thrombosis after splenectomy in patients with liver cirrhosis and hypersplenism[J].Ann Surg,2010,251(1):76-83.

[15]QI X,CHEN H,HAN G.Effect of antithrombin,protein C and protein S on portal vein thrombosis in liver cirrhosis:a meta-analysis[J].Am J Med Sci,2013,346(1):38-44.

[16]CHEN H,QI X,HE C,et al.Coagulation imbalance may not contribute to the development of portal vein thrombosis in patients with cirrhosis[J].Thromb Res,2013,131(2):173-177.

[17]WU S,WU Z,ZHANG X,et al.The incidence and risk factors of portal vein system thrombosis after splenectomy and pericardial devascularization[J].Turk J Gastroenterol,2015,26(5):423-428.

[18]AMITRANO L,BRANCACCIO V,GUARDASCIONE MA,et al.Inherited coagulation disorders in cirrhotic patients with portal vein thrombosis[J].Hepatology,2000,31(2):345-348.

[19]ZHANG WW,QI XS,GUO XZ.Significance of factorⅡG20210A mutation in Budd-Chiari syndrome and portal vein thrombosis[J].J Clin Hepatol,2015,31(2):310-314.(in Chinese)张文文,祁兴顺,郭晓钟.凝血因子ⅡG20210A突变在布加综合征和门静脉血栓形成中的意义[J].临床肝胆病杂志,2015,31(2):310-314.

[20]QI X,REN W,DE SV,et al.Associations of coagulation factor VLeiden and prothrombin G20210A mutations with Budd-Chiari syndrome and portal vein thrombosis:a systematic review and meta-analysis[J].Clin Gastroenterol Hepatol,2014,12(11):1801-1812.

[21]MANGIA A,VILLANI MR,CAPPUCCI G,et al.Causes of portal venous thrombosis in cirrhotic patients:the role of genetic and biologic factors[J].Eur J Gastroenterol Hepatol,2005,17(7):745-751.

[22]MA J,YAN Z,LUO J,et al.Rational classification of portal vein thrombosis and its clinical significance[J].PLoS One,2014,9(11):e112501.

[23]SENZOLO M,TIBBALS J,CHOLOMGITAS E,et al.Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with and without cavernous transformation[J].Aliment Pharmacol Ther,2006,23(6):767-775.

[24]PONZIANI FR.Portal vein thrombosis:insight into physiopathology,diagnosis,and treatment[J].World J Gastroenterol,2010,16(2):143.

[25]TREBICHA J,STRASSBURG CP.Etiology and complications of portal vein thrombosis[J].Viszeralmedizin,2014,30(6):375-380.

[26]TSOCHATZIS EA,BOSCH J,BURROGHS AK.Liver cirrhosis[J].The Lancet,2014,383(9930):1749-1761.

[27]QI X,HAN G,WANG J,et al.Degree of portal vein thrombosis[J].Hepatology,2010,51(3):1089-1090.

[28]RAJESH S,MUKUND A,ARORA A.Imaging diagnosis of splanchnic venous thrombosis[J].Gastroenterol Res Pract,2015,2015:101029.

[29]BERZIGOTTI A,GARCA-CRIADO A,DARNELL A,et al.Imaging in clinical decision-making for portal vein thrombosis[J].Nat Rev Gastroenterol Hepatol,2014,11(5):308-316.

[30]AGENO W,RIVA N,SCHULMAN S,et al.Long-term clinical outcomes of splanchnic vein thrombosis:results of an international registry[J].JAMA Intern Med,2015,175(9):1474-1480.

[31]CUI SB,SHU RH,YAN SP,et al.Efficacy and safety of anticoagulation therapy with different doses of enoxaparin for portal vein thrombosis in cirrhotic patients with hepatitis B[J].Eur J Gastroenterol Hepatol,2015,27(8):914-919.

[32]CHEN H,LIU L,QI X,et al.Efficacy and safety of anticoagulation in more advanced portal vein thrombosis in patients with liver cirrhosis[J].Eur J Gastroenterol Hepatol,2016,28(1):82-89.

[33]HUARD G,BILODEAU M.Management of anticoagulation for portal vein thrombosis in individuals with cirrhosis:a systematic review[J].Int J Hepatol,2012,2012:672986.

[34]CONGLY SE,LEE SS.Portal vein thrombosis:should anticoagulation be used?[J].Curr Gastroenterol Rep,2013,15(2):306.

[35]RODRIGUEZ-CASTRO KI,SIMIONI P,BURRA P,et al.Anticoagulation for the treatment of thrombotic complications in patients with cirrhosis[J].Liver International,2012,32(10):1465-1476.

[36]QI X,HAN G,FAN D.Management of portal vein thrombosis in liver cirrhosis[J].Nat Rev Gastroenterol Hepatol,2014,11(7):435-446.

[37]WANG Z,JIANG MS,ZHANG HL,et al.Is post-TIPS anticoagulation therapy necessary in patients with cirrhosis and portal vein thrombosis?A randomized controlled trial[J].Radiology,2016,279(3):943-951.

[38]UFLACHER R.Applications of percutaneous mechanical thrombectomy in transjugular intrahepatic portosystemic shunt and portal vein thrombosis[J].Tech Vasc Interv Radiol,2003,6(1):59-69.

[39]BERRY K,TAYLOR J,LIOU IW,et al.Portal vein thrombosis is not associated with increased mortality among patients with cirrhosis[J].Clin Gastroenterol Hepatol,2015,13(3):585-593.

[40]QI X,DAI J,YANG M,et al.Association between portal vein thrombosis and survival in non-liver-transplant patients with liver cirrhosis:a systematic review of the literature[J].Gastroenterol Res Pract,2015,2015:480842.

[41]ENGLESBE MJ,SCHAUBEL DE,CAI S,et al.Portal vein thrombosis and liver transplant survival benefit[J].Liver Transpl,2010,16(8):999-1005.

[42]JOHN BV,KONJETI R,AGGRAWAL A,et al.Impact of untreated portal vein thrombosis on pre and post liver transplant outcomes in cirrhosis[J].Ann Hepatol,2013,12(6):952-958.

[43]RAMOS AP,REIGADA CPH,ATADE EC,et al.Portal vein thrombosis and liver transplantation:long term[J].Transplant Proc,2010,42(2):498-501.

[44]GHABRI M,AGARWAL S,LACERDA M,et al.Portal vein thrombosis is a risk factor for poor early outcomes after liver transplantation:analysis of risk factors and outcomes for portal vein thrombosis in waitlisted patients[J].Transplantation,2016,100(1):126-133.

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