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摘要：
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摘要：目的 探讨乙型肝炎肝硬化食管胃静脉曲张（gastroesophageal varices，GOV）
合并门静脉血栓（portal vein thrombosis，PVT）自发再通的影响因素。方法 回顾性
连续纳入2008年10月31日至2018年10月31日就诊于首都医科大学附属北京地坛医院
的238例乙型肝炎肝硬化GOV合并PVT患者，采集患者基线临床指标，每3～6个月随
访观察PVT是否自发再通，根据PVT再通情况分为PVT再通组（64例）和PVT未再通组
（174例），采用单因素及多因素Logistic回归分析PVT自发再通的影响因素。结果 患者平
均（50.1 ± 10.0）岁，中位随访时间为67个月，随访过程中共64例（26.9%）患者出现
PVT自发再通，174例患者未再通。PVT再通组患者门静脉主干栓塞 [45.3%（29/64）比
63.8%（111/174）；χ2 = 6.598，P = 0.010]、腹水 [70.3%（45/64）比83.9%（146/174）；
χ2 = 5.457，P = 0.019]、吸烟史 [17.2%（11/64）比35.1%（61/174）；χ2 = 7.081，P = 0.008]
及饮酒史 [18.8%（12/64）比39.7%（69/174）；χ2 = 9.108，P = 0.003] 比例均显著低于
PVT未再通组。多因素Logistic回归分析表明饮酒（OR = 2.761，95%CI：1.355～5.626，
P = 0.005）、门静脉主干栓塞（OR = 1.976，95%CI：1.085～3.599，P = 0.026）、合并腹
水（OR = 2.247，95%CI：1.116～4.527，P = 0.023）为PVT未自发再通的独立危险因素。
结论 26.9%的乙型肝炎肝硬化GOV合并PVT患者发生了自发再通。门静脉主干栓塞、合
并腹水、有饮酒史为乙型肝炎肝硬化GOV合并PVT患者未自发再通的独立危险因素。
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Abstract: Objective To investigate the factors affecting spontaneous recanalization of portal vein
thrombosis (PVT) in patients with hepatitis B virus-related liver cirrhosis and esophagogastric
varices (GOV). Methods Total of 238 hepatitis B virus-related liver cirrhosis with GOV patients
complicated with PVT admitted to Beijing Ditan Hospital, Capital Medical University from
October 31st, 2008 to October 31st, 2018 were retrospectively included. Baseline characteristics
of the patients were collected. PVT recanalization was observed every 3～6 months. Patients
were divided into PVT spontaneous recanalization group (64 cases) and non-spontaneous
recanalization group (174 cases) according to the PVT recanalization. Univariate and multivariate
Logistic regression analysis were used to investigate the influencing factors of PVT spontaneous
recanalization. Results The average age of the patients was (50.1 ± 10.0) years old and the
median follow-up time was 67 months. During the follow-up time, 64 patients (26.9%) had
spontaneous recanalization of PVT while 174 patients had no spontaneous recanalization.
The proportion of patients with main portal vein thrombosis [45.3% (29/64) vs. 63.8% (111/174);
χ2 = 6.598, P = 0.010], ascites [70.3% (45/64) vs. 83.9% (146/174); χ2 = 5.457, P = 0.019],
smoking history [17.2% (11/64) vs. 35.1% (61/174); χ2 = 7.081, P = 0.008)] and drinking history
[18.8% (12/64) vs. 39.7% (69/174); χ2 = 9.108, P = 0.003] in PVT spontaneous recanalization
group were significantly lower than those in non-spontaneous recanalization group. Multivariate
Logistic regression analysis showed that history of drinking (OR = 2.761, 95%CI: 1.355～5.626,
P = 0.005), main portal embolism (OR = 1.976, 95%CI: 1.085～3.599, P = 0.026) and
ascites (OR = 2.247, 95%CI: 1.116～4.527, P = 0.023) were independent risk factors of nonspontaneous
recanalization of PVT. Conclusions Spontaneous PVT recanalization occurred
in 26.9% of HBV-related liver cirrhotic patients with GOV and complicated with PVT. Main
portal embolism, ascites and drinking history were the independent risk factors for failure of
spontaneous recanalization in GOV patients complicated with PVT.
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