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portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis

World Journal of Gastroenterology 2018年第35期24卷 4054-4060页

作者： Ling Ding Feng Deng Chen Yu Wen-Hua He Liang Xia Mi Zhou Xin Huang Yu-Peng Lei Xiao-Jiang Zhou Yin Zhu Nong-Hua Lu Medical College of Nanchang University Nanchang 330006Jiangxi ProvinceChina Department of medical image The First Affiliated Hospital of Nanchang UniversityNanchang 330006Jiangxi ProvinceChina Department of Gastroenterology The First Affiliated Hospital of Nanchang UniversityNanchang 330006Jiangxi ProvinceChina

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 *** 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 *** High Balthazar's CTSI scores, hypoalbuminemia and gastrointestinal wall thickening are independent risk factors for PSMVT developed in the early stage of SAP.

关键词： Vascular complication portosplenomesenteric vein thrombosis Severe acute pancreatitis Early stage Risk factors Contrast-enhanced computed tomography

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