TIPS术后肝硬化门静脉高压患者脾脏体积和血细胞变化
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R575.2

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国家自然科学基金(81701802)


The changes of splenic volume and blood corpuscle in patients with portal hypertension due to liver cirrhosis after TIPS
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    目的:评估肝硬化门静脉高压患者行经颈内静脉肝内门体静脉分流术(transjugular intrahepatic portosystemic shunt, TIPS)对脾脏体积和血细胞的影响。方法:回顾性收集南京医科大学第一附属医院介入放射科2015年5月—2020年12月的 120 例肝硬化门静脉高压患者行 TIPS 术前、术后(1、3、6、12 个月)的一般情况、实验室及 CT 影像学信息,使用 Friedman 检验和 Spearman 相关分析评价 TIPS 手术前后脾脏体积、血小板计数、血红蛋白和白细胞计数变化情况。结果:120 例患者术前至术后 12个月各项观察指标中,脾脏体积从术前749.3(479.0,1152.2)cm3 缩小至577.4(343.0,884.1)cm3 (P < 0.001),血小板计数从50(40,80)×109 个/L增加至86.5(60,124)×109 个/L(P < 0.001),血红蛋白从81(70,94)g/L增加至121(106,132)g/L (P < 0.001),白细胞计数从 4.1(2.5,6.6)×109 个/L 增加至 5.9(5.0,7.0)×109 个/L(P < 0.001)。术后第 1 个月脾脏体积和血细胞的变化率最大,脾脏缩小6.5%,而血小板计数、血红蛋白、白细胞计数分别增加15.1%、17.3%、11.2%,且血小板增加率与脾脏体积缩小率明显相关(P < 0.05)。结论:TIPS术后脾脏体积缩小,血小板计数、血红蛋白和白细胞计数增加,并且在术后第1个月改善最明显。血小板增加率与脾脏体积缩小率明显相关。

    Abstract:

    Objective:To evaluate the impact of transjugular intrahepatic portosystemic shunt(TIPS)on splenic volume and blood corpuscle. Methods:The general information,laboratory and CT imaging data of 120 patients with portal hypertension due to cirrhosis were retrospectively collected before and 1,3,6 and 12 months after TIPS from May 2015 to December 2020 in Department of Interventional Radiology,the First Affiliated Hospital of Nanjing Medical University. The changes of splenic volume,platelet count,hemoglobin,and leukocyte count before and after TIPS were evaluated by Friedman test and Spearman correlation analysis. Results:Changes of observed indexes of 120 patients from preoperation to postoperative 12 months:the splenic volume decreased from 749.3(479.0,1152.2)cm3 to 577.4(343.0,884.1)cm3 (P < 0.001),platelet(PLT)count increased from 50(40,80)×109 /L to 86.5(60,124)×109 /L(P < 0.001),hemoglobin(Hb)increased from 81(70,94)g/L to 121(106,132)g/L(P < 0.001)and the leukocyte (WBC)count increased from 4.1(2.5,6.6)×109 /L to 5.9(5.0,7.0)×109 /L(P < 0.001). The rate of change in splenic volume and corpuscle was the most obvious in the first month after TIPS and the spleen had shunk by 6.5%,and the PLT count,Hb,and WBC count increased by 15.1%,17.3% and 11.2% respectively. In addition,the rate of increase in PLT was significantly correlated with the rate of decrease in splenic volume. Conclusion:The splenic volume is decreased and PLT count,Hb and WBC count are increased after TIPS,and the improvement is the most obvious in the first month after TIPS. The rate of increase in PLT is significantly related to the rate of decrease in splenic vloume.

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侍齐,杨魏,周海峰,刘圣,施海彬,周卫忠. TIPS术后肝硬化门静脉高压患者脾脏体积和血细胞变化[J].南京医科大学学报(自然科学版),2023,(1):60-65

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  • 在线发布日期: 2023-01-17
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