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Transjugular Intrahepatic Portosystemic Shunt Placement in Patients with Schistosomiasis-Induced Liver Fibrosis.
CardioVascular and Interventional Radiology ( IF 2.9 ) Pub Date : 2019-07-30 , DOI: 10.1007/s00270-019-02295-6 Jiacheng Liu 1, 2 , Binqian Zhou 2, 3 , Dongpin Chen 1, 2 , Chen Zhou 1, 2 , Qin Shi 1, 2 , Chuansheng Zheng 1, 2 , Gansheng Feng 1, 2 , Feng Yuan 1, 2 , Yan Ge 1, 2 , Bin Xiong 1, 2
CardioVascular and Interventional Radiology ( IF 2.9 ) Pub Date : 2019-07-30 , DOI: 10.1007/s00270-019-02295-6 Jiacheng Liu 1, 2 , Binqian Zhou 2, 3 , Dongpin Chen 1, 2 , Chen Zhou 1, 2 , Qin Shi 1, 2 , Chuansheng Zheng 1, 2 , Gansheng Feng 1, 2 , Feng Yuan 1, 2 , Yan Ge 1, 2 , Bin Xiong 1, 2
Affiliation
PURPOSE
Evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) insertion on patients with schistosomiasis-induced liver fibrosis, and compare with that of patients with HBV-induced cirrhosis.
MATERIALS AND METHODS
This was a retrospective study from November 2015 to December 2018 including 82 patients diagnosed with portal hypertension, one group of which is induced by schistosomiasis (n = 20), the other by hepatitis B virus (HBV) (n = 62). Both groups of subjects underwent TIPS placement for the management of portal hypertension complications.
RESULTS
TIPS was inserted successfully in all patients (technical success 100%). After a median follow-up of 14 months following TIPS insertion, portal pressure gradient (PPG) value in both schistosomiasis-induced group and HBV-induced group underwent a significant decrease with no major difference between the two groups. There exists no significant difference demonstrated by Kaplan-Meier curves between two groups concerning cumulative rate of hepatic encephalopathy (HE) (log-rank p = 0.681), variceal rebleeding (log-rank p = 0.837) and survival (log-rank p = 0.429), and no statistically difference was found in terms of alleviation of portal vein thrombosis (PVT). In addition, splenectomy (HR 19, 95% CI 4-90, p < 0.001) was identified as independent predictor of PVT.
CONCLUSIONS
TIPS placement is well-founded to be considered as a safe and effective treatment in patients with schistosomiasis-induced portal hypertension and relevant severe complications. We also found the risk of PVT is 19 times higher in patients who underwent splenectomy than in untreated patients.
LEVEL OF EVIDENCE
Historically controlled studies, level 4.
中文翻译：
血吸虫病诱发的肝纤维化患者的经颈静脉肝内门体分流术放置。
目的评估经颈静脉内肝门系统分流术（TIPS）对血吸虫病引起的肝纤维化患者的疗效和安全性，并与HBV引起的肝硬化患者进行比较。材料与方法这项回顾性研究于2015年11月至2018年12月进行，包括82位被诊断为门脉高压的患者，其中一组是由血吸虫病诱发的（n = 20），另一组是由乙型肝炎病毒（HBV）引起的（n = 62）。 。两组受试者均接受TIPS放置以治疗门静脉高压症并发症。结果TIPS成功插入所有患者中（技术成功率为100％）。在TIPS植入后进行了14个月的中位随访后，血吸虫病诱导组和HBV诱导组的门脉压力梯度（PPG）值均显着降低，两组之间无重大差异。两组之间在肝性脑病（HE）累积率（log-rank p = 0.681），静脉曲张再出血（log-rank p = 0.837）和生存率（log-rank p = 0.429），在缓解门静脉血栓形成（PVT）方面没有统计学差异。此外，脾切除术（HR 19，95％CI 4-90，p <0.001）被确定为PVT的独立预测因子。结论众所周知，在患有血吸虫病诱发的门脉高压症和相关严重并发症的患者中，TIPS放置是一种安全有效的治疗方法。我们还发现接受脾切除术的患者的PVT风险比未经治疗的患者高19倍。证据级别历史对照研究，第4级。
更新日期：2019-07-30
中文翻译：
血吸虫病诱发的肝纤维化患者的经颈静脉肝内门体分流术放置。
目的评估经颈静脉内肝门系统分流术（TIPS）对血吸虫病引起的肝纤维化患者的疗效和安全性，并与HBV引起的肝硬化患者进行比较。材料与方法这项回顾性研究于2015年11月至2018年12月进行，包括82位被诊断为门脉高压的患者，其中一组是由血吸虫病诱发的（n = 20），另一组是由乙型肝炎病毒（HBV）引起的（n = 62）。 。两组受试者均接受TIPS放置以治疗门静脉高压症并发症。结果TIPS成功插入所有患者中（技术成功率为100％）。在TIPS植入后进行了14个月的中位随访后，血吸虫病诱导组和HBV诱导组的门脉压力梯度（PPG）值均显着降低，两组之间无重大差异。两组之间在肝性脑病（HE）累积率（log-rank p = 0.681），静脉曲张再出血（log-rank p = 0.837）和生存率（log-rank p = 0.429），在缓解门静脉血栓形成（PVT）方面没有统计学差异。此外，脾切除术（HR 19，95％CI 4-90，p <0.001）被确定为PVT的独立预测因子。结论众所周知，在患有血吸虫病诱发的门脉高压症和相关严重并发症的患者中，TIPS放置是一种安全有效的治疗方法。我们还发现接受脾切除术的患者的PVT风险比未经治疗的患者高19倍。证据级别历史对照研究，第4级。
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