Hepatic venous pressure gradient and rebleeding risk of patients with nonalcoholic steatohepatitis cirrhosis after variceal bleeding

作者全名："Shi, Yiqi; Shen, Wenyong; Xu, Gang; Wang, Xunzheng; Ning, Bo"

作者地址："[Shi, Yiqi; Ning, Bo] Chongqing Med Univ, Yuzhong Hosp, Affiliated Hosp 2, Digest Syst Dept, Chongqing, Peoples R China; [Shen, Wenyong; Xu, Gang] Chongqing Univ, Chongqing Fuling Cent Hosp, Digest Syst Dept, Chongqing, Peoples R China; [Wang, Xunzheng] Chongqing Med Univ, Jiangnan Hosp, Affiliated Hosp 2, Digest Syst Dept, Chongqing, Peoples R China"

通信作者："Ning, B (通讯作者)，Chongqing Med Univ, Yuzhong Hosp, Affiliated Hosp 2, Digest Syst Dept, Chongqing, Peoples R China."

来源：FRONTIERS IN MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001043712300001

JCR分区：Q1

影响因子：3.1

年份：2023

卷号：10

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：nonalcoholic steatohepatitis (NASH); hepatitis B virus (HBV); transjugular intrahepatic portosystemic shunt (TIPS); variceal bleeding; hepatic venous pressure gradient (HVPG)

摘要："Background and aimsHepatic venous pressure gradient (HVPG) has a strong predictive value for variceal rebleeding in cirrhotic patients, but the accuracy of HVPG may be compromised in nonalcoholic steatohepatitis (NASH) cirrhosis. This study aimed to evaluate the accuracy of HVPG and portal pressure gradient (PPG) for predicting rebleeding in NASH cirrhosis after acute variceal bleeding. Patients and methodsThirty-eight NASH cirrhosis patients and 82 hepatitis B virus (HBV) cirrhosis patients with acute variceal bleeding were included in this study. All patients recived transjugular intrahepatic portalsystemic shunt (TIPS). The prognostic value of HVPG and PPG for variceal rebleeding was evaluated. ResultsCompared with HBV cirrhosis, NASH cirrhosis demonstrated a lower HVPG (15.3 & PLUSMN; 3.8 vs. 18.0 & PLUSMN; 4.8; p = 0.003) and lower PPG (18.0 & PLUSMN; 3.7 vs. 20.0 & PLUSMN; 3.4; p = 0.005). HVPG (AUC = 0.82; p = 0.002) and PPG (AUC = 0.72; p = 0.027) had promising prognostic value among NASH cirrhosis patients. The optimal threshold of HVPG and PPG for predicting rebleeding in NASH cirrhosis was 17 mmHg and 20 mmHg. At multivariate analysis, HVPG & GE;17 mmHg was a significant predictor of variceal rebleeding (HR 9.40; 95% CI 1.85-47.70; p = 0.007). ConclusionIn the patients with cirrhosis and vairceal bleeding, the levels of HVPG and PPG were found to be low in NASH cirrhosis than HBV cirrhosis. However, the prevalence of rebleeding was similar between two groups. HVPG measurement is still an accurate way to assess the risk of variceal rebleeding in NASH cirrhosis."

基金机构：medical study plan of Chongqing Health Commission [2016HBRC003]

基金资助正文："This study was supported by the medical study plan of Chongqing Health Commission, Grant 2016HBRC003."