从Virchow三要素分析肝硬化患者发生门静脉血栓危险因素

doi:10.3969/j.issn.1672-5069.2015.02.032

Abstract

Abstract: Portal vein thrombosis （PVT） is more common in cirrhotic patients than in normal people, which may have adverse effect on prognosis of patients with liver cirrhosis.Virchow’s triad（hypercoagulability,vascular endothelial injury and reduced blood flow velocity） is a classic theory about thrombosis. Hypersplenism and liver dysfunction cause the change of clotting factors,and intrahepatic vascular compress by liver fibrosis,sclerotherapy,abdominal surgery,infection as well as endotoxemia may injure the endothelial cells;Portal hypertension or prophylactic medicine may block the blood flow. All of the above factors can be the risk factors of PVT. This review mainly describes the risk factors of PVT in cirrhotic patients from the view of Virchow’s triad and hopes to provide theoretical basis for the formulation of prediction method,prevention and treatment of PVT.

Key words: Liver cirrhosis, Portal vein thrombosis, Risk factors, Virchow’s triad

Li Ling, Chen Shiyao. Risk factors of portal vein thrombosis in cirrhotic patients from the view of Virchow’s triad[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2015, 18(3): 325-328.

References

[1] Rajani R,Bjornsson E,Bergquist A,et al. The epidemiology and clinical features of portal vein thrombosis：a multicentre study.Aliment Pharmacol Ther,2010,32：1154-1162.
[2] Okuda K,Ohnishi K,Kimura K,et al.Incidence of portal vein thrombosis in liver cirrhosis：An angiographic study in 708 patients.Gastroenterology,1985,89：279-286.
[3] Amitrano L,Guardascione MA,Brancaccio V,et al.Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis. J Hepatol,2004,40：736-741.
[4] Francoz C,Belghiti J,Vilgrain V,et al.Splanchnic vein thrombosis in candidates for liver transplantation：usefulness of screening and anticoagulation.Gut,2005,54（5）：691-697.
[5] Tsochatzis EA,Senzolo M,Germani G,et al. Systematic review：portal vein thrombosis in cirrhosis.Aliment Pharmacol Ther,2010,31：366-374.
[6] Ponziani FR1,Zocco MA,Garcovich M,et al.What we should know about portal vein thrombosis in cirrhotic patients：A changing perspective.World J Gastroenterol,2012,18（36）：5014-5020.
[7] Ferreira CN,Rodrigues T,Alexandrino P,et al.Portal vein thrombosis in cirrhotic patients is associated with advanced liver disease and predicts poor long term prognosis. Hepatology,2010,52：1072A.
[8] Hodge A,Crispiny P.Coagulopathy in liver disease：The whole is greater than the sum of its parts. J Gastroenterol Hepatol,2010,25（1）：1-2.
[9] Li MX,Zhang XF,Liu ZW,et al. Risk factors and clinical characteristics of portal vein thrombosis after splenectomy in patients with liver cirrhosis.Hepatobiliary Pancreat Dis Int,2013,12（5）：512-519.
[10] 梅斌,郑凯,陈孝平.断流术后门静脉血栓形成与血小板膜蛋CD62P的关系. 华中科技大学学报（医学版）,2006,35（4）：548-549.
[11] Martinelli I,Primignani M,Aghemo A,et al. High levels of factor VIII and risk of extra-hepatic portal vein obstruction. J Hepatol,2009,50：916-922.
[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 Hepatol,2009,51（4）：682-689.
[13] Bombeli T,Basic A,Fehr J. Prevalence of hereditary thrombophilia in patients with thrombosis in different venous systems.Am J Hematol,2002,70：126-132.
[14] Zhang D,Hao JY,Yang N. Protein C and D-dimer are related to portal vein thrombosis in patients with liver cirrhosis.J Gastroenterol Hepatol,2010,25（1）：116-121.
[15] Rossetto V,Spiezia L,Senzolo M,et al. Factor VIIa-antithrombin complexes in patients with non-neoplastic portal vein thrombosis with and without cirrhosis.Int J Lab Hematol,2013,35（1）：101-105.
[16] Mangia A,Villani MR,Cappucci G,et al.Causes of portal venous thrombosis in cirrhotic patients：the role of genetic and acquired factors. Eur J Gastroenterol Hepatol,2005,17（7）：745-751.
[17] Amitrano L,Brancaccio V,Guardascione MA,et al. Portal vein thrombosis after variceal endoscopic sclerotherapy in cirrhotic patients:Role of genetic thrombophilia. Endoscopy,2002,34（7）：535-538.
[18] Politoske D,Ralls P,Korula J.Portal vein thrombosis following endoscopic variceal sclerotherapy：Prospective controlled comparison in patients with cirrhosis.Dig Dis Sci,1996,41：185-190.
[19] Violi F,Ferro D,Basili S,et al.Ongoing prothrombotic state in the portal circulation of cirrhotic patients.Thromb Haemost,1997,77：44-47.
[20] Merkel C,Sacerdoti D,Bolognesi M,et al. Doppler sonography and hepatic vein catheterization in portal hypertension：assessment of agreement in evaluating severity and response to treatment. J Hepatol,1998,28（4）：622-630.
[21] Bolognesi M,Sacerdoti D,Mescoli C,et al.Different hemodynamic patterns of alcoholic and viral endstage cirrhosis：analysis of explanted liver weight,,degree of fibrosis and splanchnic Doppler parameters.Scand J Gastroenterol,2007,42：256-262.
[22] 胡培欣.卡维地洛对肝硬化患者肝静脉压力梯度及门静脉系统血流动力学影响. 山东大学2011年硕士论文:321.
[23] 刘君.心得安对肝硬化患者门静脉系统血流动力学及Tei指数的影响. 河北医科大学2009年硕士论文:213.
[24] Ayala R,Grande S,Bustelos R,et al. Obesity is an independent risk factor for pre-transplant portal vein thrombosis in liver recipients. BMC Gastroenterol,2012,12：114.
[25] Amitrano L,Brancaccio V,Guardascione MA,et al.Inherited coagulation disorders in cirrhotic patients with portal thrombosis.Hepatology,2000,31（2）：345-348.
[26] Gabr MA,Bessa SS,El-Zamarani EA.Portal vein thrombosis in Egyptian patients with liver cirrhosis：Role of methylenetetrahydrofolate reductase C677T gene mutation.Hepatol Res,2010,40（5）：486-493.
[27] Erkan O,Bozdayi AM,Disibeyaz S,et al.Thrombophilic gene mutations in cirrhotic patients with portal vein thrombosis.Eur J Gastroenterol Hepatol,2005,17（3）：339-343.
[28] Amitrano L,Guardascione MA,Brancaccio V,et al.Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis. J Hepatol,2004,40（5）：736-741.
[29] Saugel B,Lee M,Feichtinger S,et al.Thrombophilic factor analysis in cirrhotic patients with portal vein thrombosis. J Thromb Thrombolysis,2014 Aug 14.[Epub ahead of print]
[30] Primignani M,Martinelli I,Bucciarelli P,et al.Risk factors for thrombophilia in extrahepatic portal vein obstruction. Hepatology,2005,41（3）：603-608.
[31] 卢翔,赵青川,韩国宏,等. 肝硬化门静脉高压症术后门静脉血栓形成危险因素研究. 中国实用外科杂志,2013,33（3）:215-218.
[32] Northup PG,McMahon MM,Ruhl AP,et al.Coagulopathy does not fully protect hospitalized cirrhosis patients from peripheral venous thromboembolism. Am J Gastroenterol,2006,101（7）：1524-1528. quiz 1680.
[33] Ogren M,Bergqvist D,Bjorck M,et al.Portal vein thrombosis：prevalence,patient characteristics and lifetime risk：a population study based on 23,796 consecutive autopsies.World J Gastroenterol,2006,12（13）：2115-2119.
[34] Fimognari FL,De Santis A,Piccheri C,et al.Evaluation of D-dimer and factor VIII in cirrhotic patients with asymptomatic portal venous thrombosis. J Lab Clin Med,2005,146（4）：238-243.
[35] Girleanu I,Trifan A,Cojocariu C,et al.The risk of thrombotic events in patients with liver cirrhosis. Rev Med Chir Soc Med Nat Iasi,2012,116（4）：991-996.

Risk factors of portal vein thrombosis in cirrhotic patients from the view of Virchow’s triad

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	Chen Shuai, Yang Changqing.. Pathogenesis and risk factors of portal vein thrombosis [J]. Journal of Practical Hepatology, 2019, 22(6): 761-764.
[2]	Zhuang Ying, Lin Zhihui.. Clinical manifestations and diagnosis of portal vein thrombosis [J]. Journal of Practical Hepatology, 2019, 22(6): 765-767.
[3]	Bao Yingjun, Ren Weixin.. Interventional therapy for patients with portal vein thrombosis [J]. Journal of Practical Hepatology, 2019, 22(6): 768-769.
[4]	Yang Caiyong, Chen Na, Li Kui, et al.. Clinical significance of peripheral blood Treg and Th17 cells in patients with chronic hepatitis C and hepatitis C-induced liver cirrhosis [J]. Journal of Practical Hepatology, 2019, 22(6): 868-871.
[5]	Wu Dan Ma Xiangying.. Insulin resistance,carotid atherosclerosis and left ventricular function in patients with NAFLD-induced liver cirrhosis [J]. Journal of Practical Hepatology, 2019, 22(6): 876-879.
[6]	He Zhi’an, Yu Liping, Lai Jiangqiong, et al.. Evaluation of varices bleeding and portal vein thrombosis by ARFI in patients with cirrhosis and esophagogastric varices [J]. Journal of Practical Hepatology, 2019, 22(6): 888-891.
[7]	Wang Yueyuan, Wang Yan, Zhang Dandan. Short-term efficacy of terlipressin and octreotide combination in treatment of cirrhotic patients complicated by hepatorenal syndrome [J]. Journal of Practical Hepatology, 2019, 22(5): 684-687.
[8]	Zhang Mei, Shi Xiuying, Li Linjuan, et al. Hepatic expression of interferon inducible protein -10 in patients with hepatitis B liver cirrhosis and hepatogenic diabetes mellitus [J]. Journal of Practical Hepatology, 2019, 22(5): 688-691.
[9]	Dan Zhuyongji, Liu Zhilan, Lu Yanyan, et al. Efficacy of endoscopic sequential variceal 1igation plus sclerotherapy in treatment of patients with hepatitis B-induced liver cirrhosis complicated by esophageal gastric varices bleeding [J]. Journal of Practical Hepatology, 2019, 22(5): 692-695.
[10]	Huang Hanjun, Lu Fengrong, Zhang Can. Clinical value of MRI scanning based on exchange hemodynamics model in evaluating liver cirrhosis [J]. Journal of Practical Hepatology, 2019, 22(5): 696-699.
[11]	Zhao Fangfang, Zhai Yongzhen, Feng Guohe. Efficacy and safety of autologous peripheral blood stem cell transplantation in patients with hepatitis B cirrhosis [J]. Journal of Practical Hepatology, 2019, 22(5): 700-703.
[12]	Chen Shan, Zhuang Huashuai, Xing Yixi, et al. Preventive application of meropenem in patients with liver cirrhosis complicated by upper gastrointestinal bleeding [J]. Journal of Practical Hepatology, 2019, 22(5): 704-707.
[13]	Xu Qilin, Hao Shaohuan, Ran Bo. Risk factors of portal vein thrombosis after splenectomy in patients with liver cirrhosis and portal hypertension [J]. Journal of Practical Hepatology, 2019, 22(5): 708-711.
[14]	Jin Lianghong, Li Xingjie, Guan Hongbo, et al. Clinical value of dual-energy CT iodine quantification combined with dynamic contrast-enhanced MRI in evaluating hepatic hemodynamics and liver functions in patients with hepatitis B liver cirrhosis [J]. Journal of Practical Hepatology, 2019, 22(5): 712-715.
[15]	Bian Xinqu, Chen Jie, Liu Yanmin, et al. Serum thyroid hormone level changes in patients with primary biliary cholangitis receiving ursodeoxycholic acid therapy [J]. Journal of Practical Hepatology, 2019, 22(5): 716-719.