重视非肝硬化内脏静脉血栓的病因筛查

诸葛宇征

doi:10.12449/JCH240101

重视非肝硬化内脏静脉血栓的病因筛查

DOI: 10.12449/JCH240101

诸葛宇征^, ,

南京大学医学院附属南京鼓楼医院消化内科，南京 210008

利益冲突声明：本文不存在任何利益冲突。

详细信息

通信作者:
诸葛宇征， yuzheng9111963@aliyun.com （ORCID： 0000-0002-3829-5831）

计量
- 文章访问数: 235
- HTML全文浏览量: 58
- PDF下载量: 87
- 被引次数: 0
出版历程
- 收稿日期: 2023-11-22
- 录用日期: 2023-12-17
- 出版日期: 2024-01-23

Screening for the etiology of non-cirrhotic splanchnic vein thrombosis should be taken seriously in clinical practice

Yuzheng ZHUGE^{,
,}

Department of Gastroenterology，Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School，Nanjing 210008，China

More Information

Corresponding author: ZHUGE Yuzheng， yuzheng9111963@aliyun.com （ORCID： 0000-0002-3829-5831）

摘要

摘要: 非肝硬化内脏静脉血栓（NC-SVT）主要包括门静脉血栓、肠系膜上静脉血栓、脾静脉血栓和肝静脉血栓（布加综合征），其患病率随着相关基础疾病发病率升高而呈现上升趋势。由于NC-SVT严重的危害性，临床医生对其诊断意识和诊断能力也明显提高。但在治疗上往往只重视抗凝、介入等针对血栓的处理，而忽视对导致SVT的危险因素或基础疾病的筛查，一定程度上影响部分患者的血栓治疗效果，也将延误对基础疾病的诊断和治疗。本文简要介绍了与NC-SVT发生相关的获得性、遗传性及系统性、局部性基础疾病。
- 静脉血栓形成 /
- 血栓形成倾向 /
- 血液凝固因子
Abstract: Non-cirrhotic splanchnic vein thrombosis （NC-SVT） mainly includes portal vein thrombosis， superior mesenteric vein thrombosis， splenic vein thrombosis， and hepatic vein thrombosis （Budd-Chiari syndrome）， and its prevalence rate is increasing with the increase in the incidence rates of related underlying diseases. Due to the harm of NC-SVT， there have been significant improvements in the awareness and ability for diagnosis among clinicians. However， anticoagulation and intervention therapies for thrombosis are often taken seriously in treatment， while the screening for risk factors or underlying diseases leading to SVT is ignored， which may affect the treatment outcome of thrombus in some patients and delay the diagnosis and treatment of the underlying disease. This article mainly introduces the acquired， hereditary， systemic， and local underlying diseases associated with the development of NC-SVT.
- Venous Thrombosis /
- Thrombophilia /
- Blood Coagulation Factors

HTML全文

参考文献(17)

[1]	VALERIANI E, RIVA N, di NISIO M, et al. Splanchnic vein thrombosis: Current perspectives[J]. Vasc Health Risk Manag, 2019, 15: 449- 461. DOI: 10.2147/VHRM.S197732.
[2]	ELKRIEF L, PAYANCÉ A, PLESSIER A, et al. Management of splanchnic vein thrombosis[J]. JHEP Rep, 2023, 5( 4): 100667. DOI: 10.1016/j.jhepr.2022.100667.
[3]	HOW J, ZHOU A, OH ST. Splanchnic vein thrombosis in myeloproliferative neoplasms: Pathophysiology and molecular mechanisms of disease[J]. Ther Adv Hematol, 2017, 8( 3): 107- 118. DOI: 10.1177/2040620716680333.
[4]	de FRANCHIS R, BOSCH J, GARCIA-TSAO G, et al. Baveno VII-Renewing consensus in portal hypertension[J]. J Hepatol, 2022, 76( 4): 959- 974. DOI: 10.1016/j.jhep.2021.12.022.
[5]	QI X, HAN G, GUO X, et al. Review article: The aetiology of primary Budd-Chiari syndrome-differences between the West and China[J]. Aliment Pharmacol Ther, 2016, 44( 11-12): 1152- 1167. DOI: 10.1111/apt.13815.
[6]	DENNINGER MH, CHAÏT Y, CASADEVALL N, et al. Cause of portal or hepatic venous thrombosis in adults: The role of multiple concurrent factors[J]. Hepatology, 2000, 31( 3): 587- 591. DOI: 10.1002/hep.510310307.
[7]	HOEKSTRA J, LEEBEEK FWG, PLESSIER A, et al. Paroxysmal nocturnal hemoglobinuria in Budd-Chiari syndrome: Findings from a cohort study[J]. J Hepatol, 2009, 51( 4): 696- 706. DOI: 10.1016/j.jhep.2009.06.019.
[8]	LANE DA, BAYSTON T, OLDS RJ, et al. Antithrombin mutation database: 2^nd(1997) update. for the plasma coagulation inhibitors subcommittee of the scientific and standardization committee of the international society on thrombosis and haemostasis[J]. Thromb Haemost, 1997, 77( 1): 197- 211.
[9]	PRIMIGNANI M, MANNUCCI PM. The role of thrombophilia in splanchnic vein thrombosis[J]. Semin Liver Dis, 2008, 28( 3): 293- 301. DOI: 10.1055/s-0028-1085097.
[10]	POISSON J, PLESSIER A, KILADJIAN JJ, et al. Selective testing for calreticulin gene mutations in patients with splanchnic vein thrombosis: A prospective cohort study[J]. J Hepatol, 2017, 67( 3): 501- 507. DOI: 10.1016/j.jhep.2017.04.021.
[11]	PLOMPEN EPC, VALK PJM, CHU I, et al. Somatic calreticulin mutations in patients with Budd-Chiari syndrome and portal vein thrombosis[J]. Haematologica, 2015, 100( 6): e226- e228. DOI: 10.3324/haematol.2014.120857.
[12]	MURAD SD, PLESSIER A, HERNANDEZ-GUERRA M, et al. Etiology, management, and outcome of the Budd-Chiari syndrome[J]. Ann Intern Med, 2009, 151( 3): 167- 175. DOI: 10.7326/0003-4819-151-3-200908040-00004.
[13]	SØGAARD KK, FARKAS DK, PEDERSEN L, et al. Splanchnic venous thrombosis is a marker of cancer and a prognostic factor for cancer survival[J]. Blood, 2015, 126( 8): 957- 963. DOI: 10.1182/blood-2015-03-631119.
[14]	KIM AS, KHORANA AA, MCCRAE KR. Mechanisms and biomarkers of cancer-associated thrombosis[J]. Transl Res, 2020, 225: 33- 53. DOI: 10.1016/j.trsl.2020.06.012.
[15]	KANELLOPOULOU T, ALEXOPOULOU A, THEODOSSIADES G, et al. Pylephlebitis: An overview of non-cirrhotic cases and factors related to outcome[J]. Scand J Infect Dis, 2010, 42( 11-12): 804- 811. DOI: 10.3109/00365548.2010.508464.
[16]	de STEFANO V, MARTINELLI I. Splanchnic vein thrombosis: Clinical presentation, risk factors and treatment[J]. Intern Emerg Med, 2010, 5( 6): 487- 494. DOI: 10.1007/s11739-010-0413-6.
[17]	BAIGES A, PROCOPET B, SILVA-JUNIOR G, et al. Incidence and factors predictive of recurrent thrombosis in people with non-cirrhotic portal vein thrombosis[J]. J Hepatol, 2023, 78( 1): 114- 122. DOI: 10.1016/j.jhep.2022.08.023.