Abstract: Objective To compare the clinical parameters between idiopathic non-cirrhotic portal hypertension (INCPH) and virus hepatitis-related decompensated cirrhosis, and to analyze clinical and pathological features of INCPH. Methods Clinical data of 44 patients, including 23 patients with INCPH and 21 with virus hepatitis-related decompensated cirrhosis, were retrospectively analyzed. The clinical parameters were compared between the 2 groups, and the pathological characteristics of INCPH were investigated. Results The patients in INCPH group were younger (39.83 ± 15.38 years) and predominantly female (60.87%) , while the patients in decompensated cirrhosis group were older (53.33 ± 11.24 years) and predominantly male (80.95%), and the differences were statistically significant (P<0.05). The main symptom was gastrointestinal bleeding (39.13%) in INCPH group, and ascites (85.71%) in the other group (P<0.05). Red blood cell, platelet, prothrombin activity, albumin, cholinesterase in virus hepatitis-related decompensated cirrhosis group were significantly lower than those in INCPH group (P<0.05), while international normalized ratio, alanine transaminase, aspartate transaminase, total bilirubin, liver stiffness measurement and Child-Turcotte-Pugh score were significantly higher than those in INCPH group (P<0.05). And there was no significant difference in white blood cell or hemoglobin between the 2 groups (P>0.05). Compared with virus hepatitis-related decompensated cirrhosis group, INCPH group had thicker spleen, more portal vein structure disorder, more portal vein cavernous degeneration, and more collateral circulation, and the differences were statistically significant (P<0.05). However, there were no significant differences in portal vein diameter, splenic vein diameter, splenic vein diameter/portal vein diameter, incidence of splenomegaly, incidence of portal hypertensive gastropathy or degree of esophageal and gastric varices between the 2 groups (P>0.05). The liver histopathology of INCPH mainly showed that there was no obvious disorder of hepatocyte arrangement, formation of pseudo-lobe, or thrombosis in portal vein, and that there was venectasia of interlobular vein and central vein, expansion of portal area, dilation of liver sinuses, and watery degeneration of liver cells. Conclusion There were both differences and similarities in clinical manifestations, laboratory tests, and imaging indicators between INCPH and virus hepatitis-related decompensated cirrhosis, so the liver pathological examination is necessary for diagnosis.

Key words: Idiopathic non-cirrhotic portal hypertension, Virus hepatitis-related decompensated cirrhosis, Clinical, Pathology