Pathogenesis and Therapeutic Advances in Portal Vein Thrombosis under Different Etiologies

门静脉血栓是以门静脉主干及其肝内分支血栓形成的重要血管疾病，常伴随肠系膜静脉或脾静脉血栓发生。目前临床主要基于临床症状、严重程度、病因学等建立分类系统，其中病因学分类分为：慢性肝病、恶性肿瘤及特发型门静脉血栓三大类。不同病因下门静脉发病机制独具特征，通过病因精准干预成为门静脉血栓管理的核心策略。当前治疗方式主要涉及传统抗凝和经颈静脉肝内门体分流术等，尤其是门静脉支架置入术及靶向抗凝等新型疗法的突破性进展为治疗门静脉血栓提供了新思路。本文就不同病因下门静脉血栓发病机制及治疗策略的最新进展作一综述。Portal vein thrombosis is an important vascular disease characterized by thrombosis of the main trunk of the portal vein and its intrahepatic branches, which is often accompanied by thrombosis of the mesenteric vein or splenic vein. Currently, a classification system has been established based on clinical symptoms, severity and etiology, among which the etiological classification is divided into three categories: chronic liver disease, malignant tumor and idiopathic portal vein thrombosis. The pathogenesis of portal vein under different etiologies is unique, and precise intervention through etiology has become the core strategy of portal vein thrombosis management. Current treatment modalities mainly involve traditional anticoagulation and transjugular intrahepatic portosystemic shunt, etc. In particular, breakthroughs in new therapies, such as portal stenting and targeted anticoagulation, have provided new ideas for the treatment of portal vein thrombosis. In this article, we summarize the recent advances in the pathogenesis and therapeutic strategies of portal vein thrombosis under different etiologies.