关键词: 肝硬化, 脾切除, 门静脉血栓形成, 中性粒细胞胞外陷阱

Abstract: Objective This study was conducted to investigate the changes of serum neutrophil extracellular trap (NETs) markers in patients with hepatitis B liver cirrhosis (LC) complicated by portal vein thrombosis (PVT). Methods 55 patients with LC caused by hepatitis B viral infection were admitted to our hospital between September 2018 and October 2022, the clinical materials was retrieved from the HIS system and the PVT was diagnosed by ultrasonography (US). Serum myeloperoxidase (MPO), neutrophil elastase (NE) and citrullinated histone H3 (CitH3) levels were assayed by ELISA. Results The US check-up revealed PVT in 21 cases (38.2%) in our series; the model for end-stage liver disease score, the percentages of Child class C and splenectomy history in patients with PVT were 18.2(17.6,19.5), 52.4% and 42.9%, all significantly greater than [13.2(9.3,16.8), 14.7% and 2.9%, P<0.05] in patients without PVT; serum bilirubin, D-dimer, neutrophil/lymphocyte ratio, MPO, NE and CitH3 levels in patients with PVT were 25.6(21.6, 36.0)μmol/L, 1095.0(532.5, 2202.5)ng/ml, 2.3(1.9, 4.2), 42.4(20.7, 78.9)ng/ml, 2468.2(1344.8, 5620.6) ng/ml and 79.2(44.8, 126.2) ng/ml, all significantly greater than [18.9(16.5, 28.3)μmol/L, 390.0(280.0, 680.0)ng/ml, 1.9(1.2, 2.6), 10.8(5.6, 16.0)ng/ml, 623.5(241.4, 1006.3)ng/ml and 28.8(10.4, 39.6)ng/ml, respectively, P<0.05], while serum albumin level was (31.5 ± 5.8)g/L, much lower than [(35.4 ± 5.8)g/L, P<0.05] in patients without PVT. Conclusion The splenectomy might increase the incidence of PVT in patients with hepatitis B infection-induced LC, and conceal the blood routine manifestations of hypersplenism, while the increased serum NETs markers could remind the necessary of in time clinical management.

Key words: Liver cirrhosis, Splenectomy, Portal vein thrombosis, Neutrophil extracellular traps markers