Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis.
Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis.
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早期重症急性胰腺炎患者门脾肠系膜静脉血栓形成
DOI：
10.3748/wjg.v24.i35.4054
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发表时间：
2018-09-21
影响因子：
4.3
通讯作者：
Lu NH
中科院分区：
文献类型：
--
作者：
Ding L;Deng F;Yu C;He WH;Xia L;Zhou M;Huang X;Lei YP;Zhou XJ;Zhu Y;Lu NH
目的探讨重症急性胰腺炎（SAP）早期门静脉-脾-肠系膜静脉血栓形成（PSMVT）的发生率及危险因素。方法回顾性分析2014年1月至2016年12月在三级医疗机构就诊的SAP患者。所有对比增强计算机断层扫描（CT）研究被重新评估和回顾。比较SAP患者在疾病早期伴有和不伴有PSMVT的临床结果。单因素和多因素logistic回归分析依次评估SAP患者发生PSMVT的潜在危险因素。生成符合条件的独立危险因素的受试者工作特征（ROC）曲线。结果140例SAP患者中有25例（17.86%）在急性胰腺炎（AP）发病后6.19±2.43 d出现PSMVT。增强CT证实PSMVT。多因素逐步logistic回归分析显示：Balthazar的CT严重程度指数（CTSI）评分[比值比（OR）： 2.742；95%置信区间（CI）： 1.664-4.519；P = 0.000]、低白蛋白血症（血清白蛋白水平< 25 g/L） （OR: 32.573; 95%CI: 2.711-391.353; P = 0.006）和胃肠道壁增厚（OR: 4.367, 95%CI: 1.218-15.658; P = 0.024）是SAP患者发生PSMVT的独立危险因素。Balthazar的CTSI评分的ROC曲线下面积为0.777 (P = 0.000)，敏感性为52%，在截断值为5.5时特异性为93%。结论高Balthazar’s CTSI评分、低白蛋白血症和胃肠道壁增厚是SAP早期发生PSMVT的独立危险因素。
AIM To investigate the incidence and risk factors of portosplenomesenteric vein thrombosis (PSMVT) in the early stage of severe acute pancreatitis (SAP). METHODS Patients with SAP in a tertiary care setting from January 2014 to December 2016 were retrospectively reviewed. All contrast-enhanced computed tomography (CT) studies were reassessed and reviewed. Clinical outcome measures were compared between SAP patients with and without PSMVT in the early stage of the disease. Univariate and multivariate logistic regression analyses were sequentially performed to assess potential risk factors for the development of PSMVT in SAP patients. A receiver operating characteristic (ROC) curve was generated for the qualifying independent risk factors. RESULTS Twenty-five of the one hundred and forty (17.86%) SAP patients developed PSMVT 6.19 ± 2.43 d after acute pancreatitis (AP) onset. PSMVT was confirmed by contrast-enhanced CT. Multivariate stepwise logistic regression analyses showed that Balthazar’s CT severity index (CTSI) scores [odds ratio (OR): 2.742; 95% confidence interval (CI): 1.664-4.519; P = 0.000], hypoalbuminemia (serum albumin level < 25 g/L) (OR: 32.573; 95%CI: 2.711-391.353; P = 0.006) and gastrointestinal wall thickening (OR: 4.367, 95%CI: 1.218-15.658; P = 0.024) were independent risk factors for PSMVT developed in patients with SAP. The area under the ROC curve for Balthazar’s CTSI scores was 0.777 (P = 0.000), the sensitivity was 52%, and the specificity was 93% at a cut-off value of 5.5. CONCLUSION High Balthazar’s CTSI scores, hypoalbuminemia and gastrointestinal wall thickening are independent risk factors for PSMVT developed in the early stage of SAP.
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影响因子：
3.1
作者：
Cicalese, L;Sahai, A;Lee, K
通讯作者：
Lee, K
影响因子：
19.7
作者：
BALTHAZAR, EJ;ROBINSON, DL;RANSON, JHC
通讯作者：
RANSON, JHC
影响因子：
2.8
作者：
Malatino, Lorenzo;Cardella, Antonella M.;Stancanelli, Benedetta
通讯作者：
Stancanelli, Benedetta
影响因子：
3.6
作者：
Zhou, Jing;Ke, Lu;Li, Jieshou
通讯作者：
Li, Jieshou
影响因子：
5.5
作者：
Vikram, Raghunandan;Balachandran, Aparna;Charnsangavej, Chusilp
通讯作者：
Charnsangavej, Chusilp