从Virchow三要素分析肝硬化患者发生门静脉血栓危险因素

摘要

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 re-duced 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 tri-ad and hopes to provide theoretical basis for the formulation of prediction method,prevention and treatment of PVT.%肝硬化患者门静脉血栓(PVT)的发生率明显高于健康人群.门静脉血栓形成会影响患者预后.Virchow三要素(血液高凝状态、血管内皮损伤、血流速度减慢)是经典的血栓形成理论.肝硬化患者脾功能亢进、肝功能下降导致与出凝血相关的血液成分发生变化,肝纤维化压迫肝内血管,硬化剂治疗、腹部手术、感染、内毒素血症等损伤血管内皮,压迫或药物原因导致门静脉血流受阻等均可以是门静脉血栓形成的危险因素.本文主要从Virchow三要素角度入手,描述与肝硬化患者PVT形成相关的危险因素,为制定准确预测PVT发生的方法,预防和治疗PVT提供理论依据.