title: Efficacy and safety of anticoagulation therapy with different doses of enoxaparin for portal vein thrombosis in cirrhotic patients with hepatitis B.
abstract: BACKGROUND
  Patients with cirrhosis have a high incidence of portal vein thrombosis (PVT), and optimal management of PVT in cirrhotic patients remains unclear. Currently, there is no paper on optimal doses of enoxaparin for the management of PVT with cirrhosis.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of anticoagulation therapy with different doses of enoxaparin for PVT in cirrhotic patients with hepatitis B.
  
  
  METHODS
  Sixty-five patients with hepatitis B-related cirrhosis and acute PVT were treated by different doses of enoxaparin. All the patients were assigned randomly to two groups: one group received enoxaparin 1 mg/kg subcutaneously every 12 h and the other group received enoxaparin 1.5 mg/kg subcutaneously every 24 h. Clinical, biochemical evaluation, Doppler ultrasound, and contrast-enhanced computed tomography were performed during the anticoagulation treatment.
  
  
  RESULTS
  Of the 65 patients, 51 patients (78.5%) achieved complete/partial recanalization of PVT after 6 months of anticoagulation therapy. Child-Pugh scores were lower in the 51 patients who achieved complete/partial recanalization than those of the 14 nonresponders (P<0.01). No patients showed variceal bleeding during anticoagulation therapy in the two groups. The rates of nonvariceal bleeding with the use of 1.5 mg/kg every 24 h (23.5%) were higher than those with the use of 1 mg/kg every 12 h (6.4%).
  
  
  CONCLUSIONS
  Anticoagulation therapy with different doses of enoxaparin for PVT in hepatitis B patients with cirrhosis is efficient and safe, and 1 mg/kg enoxaparin subcutaneously every 12 h is a better anticoagulation regimen in the treatment of PVT in cirrhotic patients.
authors: Department of Gastroenterology, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China.
authors: Shao-bo
authors: SB
authors: Cui
authors: Rong-hua
authors: RH
authors: Shu
authors: Shi-ping
authors: SP
authors: Yan
authors: Hao
authors: H
authors: Wu
authors: Yong
authors: Y
authors: Chen
authors: Le
authors: L
authors: Wang
authors: Qiang
authors: Q
authors: Zhu
mesh_terms: D000328:Adult; D002681:China; D004334:Drug Administration Schedule; D017984:Enoxaparin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006470:Hemorrhage / Q000139:chemically induced; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007279:Injections, Subcutaneous; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology
chemical_list: D017984:Enoxaparin; D005343:Fibrinolytic Agents