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目的:探讨Budd-Chiari综合征(BCS)并发门静脉血栓形成(PVT)的相关危险因素。方法:回顾性分析郑州大学第一附属医院2010年1月—2015年12月确诊的28例BCS并发PVT患者(PVT组)与随机选取同期确诊的40例BCS未并发PVT的患者(非PVT组)的临床资料。采用单因素分析及二分类多因素非条件Logistic回归模型筛选出BCS并发PVT的独立危险因素,用受试者工作特性曲线(ROC)与曲线下面积(AUC)分析各危险因素的诊断效能,并计算最佳临界点。结果:单因素分析显示,PVT组患者在门静脉血流速度、血红蛋白明显低于非PVT组,D-二聚体(DD)、脾脏厚度水平明显高于非PVT组(均P<0.05);非条件Logistic回归模型分析显示血浆DD、门静脉血流速度、脾脏厚度是BCS并发PVT的独立危险因素(OR=31.67、0.61、1.23,均P<0.05)。ROC曲线显示,门静脉血流速度对BCS并发PVT无诊断价值(AUC<0.5),而DD、脾脏厚度的AUC分别为0.724、0.673,诊断BCS并发PVT的最佳临界点分别为0.283μg/L、49.5mm。结论:血浆DD水平、门静脉血流速度、脾脏厚度是BCS并发PVT的独立危险因素,尤其是DD>0.283μg/L、脾脏厚度>49.5mm的BCS患者,PVT发生的可能性增大。
Objective: To explore the related risk factors of Budd-Chiari syndrome (BCS) complicated with portal vein thrombosis (PVT). Methods: A retrospective analysis was performed in 28 PVS patients (PVT group) diagnosed from January 2010 to December 2015 in the First Affiliated Hospital of Zhengzhou University and 40 patients with non-PVT ) Of the clinical data. Independent risk factors of BCS complicated with PVT were screened by univariate analysis and binary classification multivariate non-conditional Logistic regression model. The diagnostic efficacy of each risk factor was analyzed by receiver operating characteristic curve (ROC) and area under the curve (AUC) Calculate the best critical point. Results: Univariate analysis showed that portal vein blood flow velocity and hemoglobin in PVT group were significantly lower than non-PVT group, D-dimer (DD) and spleen thickness were significantly higher than those in non-PVT group (all P <0.05) Logistic regression analysis showed that plasma DD, portal vein blood flow velocity and spleen thickness were independent risk factors of BCS complicated with PVT (OR = 31.67,0.61,1.23, all P <0.05). The ROC curve showed that the portal venous flow velocity had no diagnostic value for BCS complicated with PVT (AUC <0.5), while the AUC of DD and spleen thickness were 0.724 and 0.673, respectively. The best critical points for diagnosing BCS complicated with PVT were 0.283μg / L, 49.5mm. Conclusion: Plasma DD level, portal vein blood flow velocity and spleen thickness are independent risk factors of BCS complicated with PVT. Especially in BCS patients with DD> 0.283μg / L and spleen thickness> 49.5mm, PVT is more likely to occur.