Predictive value of fibrin degradation products and D-dimer combined with thromboelastography in the formation of portal vein thrombosis in patients with hepatitis B virus cirrhosis

Li Zhenzhen; Zhao Li; Li Ning

doi:10.3969/j.issn.1672-8521.2025.04.009

Abstract：Objective:To explore the predictive value of fibrin degradation product(FDP)and D-dimer combined with thromboelastography(TEG)in the formation of portal vein thrombosis(PVT)in hepatitis B virus cirrhosis.Methods:A total of 230 hepatitis B virus cirrhosis treated at General Hospital of Jinshui District Zhengzhou City from March 2020 to April 2024 were enrolled.All patients underwent imaging examination for PVT diagnosis and were stratified into PVT group(n=81)and non-PVT group(n=149).The general data,plasma FDP,D-dimer and TEG parameters(reaction time,clot formation time,clotting angle)were compared between the two groups.The risk factors of PVT formation were analyzed by multivariate Logistic regression analysis.Moreover,the predictive value of FDP,D-dimer and TEG parameters for PVT formation in patients with hepatitis B virus cirrhosis was analyzed by the receiver operating characteristic(ROC)curve.Results:Among 230 patients with hepatitis B virus cirrhosis,81 cases(35.22%)were complicated with PVT.The proportion of patients with diabetes mellitus history in PVT group(34.57%,28/81)was higher than that in non-PVT group(20.80%,31/149)(P＜0.05).and the levels of plasma FDP[(11.51±1.89)mg/L vs.(10.81±1.82)mg/L],D-dimer[(1.07±0.19)mg/L vs.(0.95±0.17)mg/L]and TEG parameters[reaction time:(6.26±1.18)min vs.(5.51±0.97)min;clot formation time:(4.42±0.87)min vs.(3.63±0.62)min;clotting angle:(51.57±9.81)˚ vs.(48.69±9.06)˚]were statistically significant between the two groups(t=2.749,4.903,5.182,7.974,and 2.236 respectively,P＜0.05).Multivariate Logistic regression analysis showed that plasma FDP,D-dimer,reaction time and clot formation time were all risk factors for the formation of PVT in hepatitis B virus cirrhosis patients(P＜0.05).ROC curve analysis verified that area under the curve(AUC)of FDP,D-dimer,reaction time,clot formation time and combined detection of the four indicators for predicting PVT formation were 0.734,0.771,0.773,0.779 and 0.933,respectively.The predictive effect of the combined detection was the best.Compared with the prdictive effect of a single indicator,the differences were statistically significant(P＜0.05).Conclusions:The combined detection of FDP,D-dimer,TEG parameters(reaction time and clot formation time)demonstrates a higher predictive value for PVT formation in patients with hepatitis B virus cirrhosis than that predicted by a single index.