Spleen Enlargement on Follow-Up Evaluation: A Noninvasive Predictor of Complications of Portal Hypertension in Cirrhosis
Spleen Enlargement on Follow-Up Evaluation: A Noninvasive Predictor of Complications of Portal Hypertension in Cirrhosis
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DOI：
10.1016/j.cgh.2008.05.004
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发表时间：
2008-10-01
影响因子：
12.6
通讯作者：
Zoli, Marco
中科院分区：
文献类型：
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作者：
Berzigotti, Annalisa;Zappoli, Paola;Zoli, Marco
背景与目的：大多数但不是所有的肝硬变患者都可见脾肿大，且更常见于出现门脉高压并发症的患者。我们的目的是验证以下假设：随着时间的推移，肝硬变患者的脾增大，进行性增大可能与门脉高压相关事件有关。方法：纳入127例肝硬变患者，肝功能Child-Pugh评分6.7+/-1.7，范围5-11，均经临床、内窥镜、腹部超声定期随访至少1年。在每次超声检查时记录脾直径。计算脾直径随时间的变化。记录随访评价时肝硬变临床并发症发生情况。结果：包涵体时，脾直径为14.9+/-3.1 cm，83%患者有脾肿大。失代偿期患者(n=39)较代偿期患者(n=88)脾大(16.1±/-3.5vs14.5+/-2.7，P=0.012)。平均随访期为53+/-37个月。随着时间推移，脾逐渐增大(方差分析，P
Background & Aims: Splenomegaly is observed in most but not all patients with cirrhosis, and has been detected more often in patients showing complications of portal hypertension. We aimed to test the hypotheses that spleen enlarges over time in cirrhosis, and that a progressive enlargement may be associated with portal hypertension-related events. Methods: A total of 127 cirrhotic patients (Child-Pugh, 6.7 +/- 1.7; range, 5-11), observed at our center and followed-up clinically, encloscopically, and with periodic abdominal ultrasound for at least 1 year, were included. Spleen diameter was recorded at each ultrasound examination. The change of spleen diameter over time was calculated. The occurrence of clinical complications of cirrhosis on follow-up evaluation was recorded. Results: At inclusion, spleen diameter was 14.9 +/- 3.1 cm; 83% of the patients had splenomegaly. Spleen was larger in patients with decompensated disease (n = 39) versus patients with compensated disease (n = 88) (16.1 +/- 3.5 vs 14.5 +/- 2.7; P =.012). The mean follow-up period was 53 +/- 37 months. Spleen progressively enlarged over time (analysis of variance, P