基于可控扩张支架体系的阶梯式TIPS:一项多中心随机对照研究

注册号:

Registration number:

ChiCTR2600125766 

最近更新日期:

Date of Last Refreshed on:

2026-05-31 20:58:52 

注册时间:

Date of Registration:

2026-05-31 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

基于可控扩张支架体系的阶梯式TIPS:一项多中心随机对照研究

Public title:

Stepwise TIPS Based on a Controlled-Expansion Stent System: A Multicenter Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于可控扩张支架体系的阶梯式TIPS:一项多中心随机对照研究

Scientific title:

Stepwise TIPS Based on a Controlled-Expansion Stent System: A Multicenter Randomized Controlled Trial

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

罗剑钧 

研究负责人:

罗剑钧 

Applicant:

Jianjun Luo 

Study leader:

Jianjun Luo 

申请注册联系人电话:

Applicant telephone:

+86 153 0080 0662

研究负责人电话:

Study leader's
telephone:

+86 153 0080 0662

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

luo.jianjun@zs-hospital.sh.cn

研究负责人电子邮件:

Study leader's E-mail:

luo.jianjun@zs-hospital.sh.cn

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

上海市徐汇区枫林路180号

研究负责人通讯地址:

上海市徐汇区枫林路180号

Applicant address:

No. 180 Fenglin Road, Xuhui District, Shanghai, China

Study leader's address:

No. 180 Fenglin Road, Xuhui District, Shanghai, China

申请注册联系人邮政编码:

Applicant postcode:

200032

研究负责人邮政编码:

Study leader's postcode:

200032

申请人所在单位:

复旦大学附属中山医院

Applicant's institution:

Zhongshan hospital,Fudan university

研究负责人所在单位:

复旦大学附属中山医院

Affiliation of the Leader:

Zhongshan hospital,Fudan university

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

B2026-284R

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

复旦大学附属中山医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee, Zhongshan Hospital, Fudan University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-05-22 00:00:00

伦理委员会联系人:

复旦大学附属中山医院医学伦理委员会

Contact Name of the ethic committee:

Medical Ethics Committee, Zhongshan Hospital, Fudan University

伦理委员会联系地址:

上海市徐汇区枫林路180号

Contact Address of the ethic committee:

No. 180 Fenglin Road, Xuhui District, Shanghai, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 21 3158 7871

伦理委员会联系人邮箱:

Contact email of the ethic committee:

ec@zs-hospital.sh.cn

研究实施负责(组长)单位:

复旦大学附属中山医院

Primary sponsor:

Zhongshan hospital,Fudan university

研究实施负责(组长)单位地址:

上海市徐汇区枫林路180号

Primary sponsor's address:

No. 180 Fenglin Road, Xuhui District, Shanghai, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海市

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

复旦大学附属中山医院

具体地址:

上海市徐汇区枫林路180号

Institution
hospital:

zhongshan hospital, fundan university

Address:

No. 180 Fenglin Road, Xuhui District, Shanghai, China.

经费或物资来源:

复旦大学附属中山医院临床研究专项

Source(s) of funding:

Clinical Research Program, Zhongshan Hospital, Fudan University

研究疾病:

门脉高压  

Target disease:

Portal hypertension

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

拟通过肝功能进行匹配分组,开展随机对照研究,通过比较阶梯式 TIPS 与标准直径组(8mm)临床结局,进一步验证阶梯式 TIPS 在保证 TIPS 治疗疗效的前提下能有效减少术后显性肝性脑病的发生率。  

Objectives of Study:

We plan to perform matched grouping based on liver function and conduct a randomized controlled study. By comparing the clinical outcomes of stepwise transjugular intrahepatic portosystemic shunt (TIPS) versus the standard diameter (8 mm) group, we aim to further validate that stepwise TIPS can effectively reduce the incidence of postoperative overt hepatic encephalopathy while ensuring the therapeutic efficacy of TIPS.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1. 严重肝功能衰竭:Child-Pugh评分 > 12分,或MELD评分 > 19分; 2. 既往HE病史:术前3个月内有反复发作的自发性显性HE史; 3. 恶性肿瘤:合并原发性肝癌(超出米兰标准)或其他恶性肿瘤,预期生存期<12个月; 4. 严重心肾功能不全:心功能III-IV级,中度-重度肺动脉高压或未控制的肾功能衰竭; 5. 门静脉血栓:门静脉海绵样变性或广泛门静脉血栓(PVT)导致无法通过介入建立通道; 6. 解剖异常:肝内血管解剖结构严重变异,不适合行TIPS术; 7. 精神疾病:无法准确评估神经精神状态者; 8. 门静脉高压既往接受过外科性分流、断流、脾切除等治疗者; 9. 先前TIPS或肝移植。

Exclusion criteria:

1. Severe liver failure: Child-Pugh score > 12 or MELD score > 19; 2. Prior history of hepatic encephalopathy (HE): recurrent spontaneous overt HE within 3 months before the procedure; 3. Malignancy: concomitant hepatocellular carcinoma (HCC) beyond the Milan criteria or other malignancies with an expected survival < 12 months; 4. Severe cardiac or renal dysfunction: New York Heart Association (NYHA) class III–IV heart failure, moderate-to-severe pulmonary hypertension, or uncontrolled renal failure; 5. Portal vein thrombosis (PVT): cavernous transformation of the portal vein or extensive PVT precluding the establishment of an interventional access; 6. Anatomical abnormalities: severe anatomical variations of the intrahepatic vasculature making TIPS unsuitable; 7. Psychiatric disorders: inability to accurately assess neuropsychiatric status; 8. Prior surgical treatment for portal hypertension: history of surgical shunt, devascularization, or splenectomy; 9. Previous TIPS or liver transplantation.

研究实施时间:

Study execute time:

From 2026-06-01 00:00:00 To 2030-06-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-06-01 00:00:00 To 2027-06-01 00:00:00

干预措施:

Interventions:

组别:

试验组

样本量:

133

Group:

Stepwise TIPS

Sample size:

干预措施:

阶梯式TIPS

干预措施代码:

Intervention:

stepwise TIPS

Intervention code:

组别:

对照组

样本量:

133

Group:

Control group

Sample size:

干预措施:

标准直径TIPS

干预措施代码:

Intervention:

Standard diameter TIPS

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

复旦大学附属中山医院 

单位级别:

三甲 

Institution
hospital:

Zhongshan hospital, fundan university

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

复旦大学附属华山医院 

单位级别:

三甲 

Institution
hospital:

Shan hospital, fundan university

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

北京 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

首都医科大学附属北京佑安医院 

单位级别:

三甲 

Institution
hospital:

Beijing Youan Hospital, Capital Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山西省 

市(区县):

 

Country:

China

Province:

Shanxi

City:

单位(医院):

山西医科大学附属第一医院 

单位级别:

三甲 

Institution
hospital:

First Hospital of Shanxi Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

潍坊市人民医院 

单位级别:

三甲 

Institution
hospital:

Weifang People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

浙江 

市(区县):

 

Country:

China

Province:

Zhejiang

City:

单位(医院):

金华市中心医院 

单位级别:

三甲 

Institution
hospital:

Jinhua Central Hospital

Level of the institution:

Tertiary

测量指标:

Outcomes:

指标中文名:

显性肝性脑病

指标类型:

主要指标

Outcome:

Overt hepatic encephalopathy

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后保存  

说明

Fate of sample:

Preservation after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 75 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

本研究不设计盲法。采用中央随机系统(IWRS),考虑到各研究中心预期入组的受试者数量相对较少,为确保各分层及各中心内两组受试者分配数量的均衡性,本研究采用长度为 4、6的可变区组,按1:1比例将受试者随机分配至试验组(可控扩张支架体系的阶梯式TIPS组)和对照组(标准直径组)。分层因素:1.肝功能储备:Child-Pugh A级 vs Child-Pugh B/C级(C级限制评分<12分)。2.中心效应:按研究中心分层。

Randomization Procedure (please state who generates the random number sequence and by what method):

This study will not employ a blinding design. A centralized interactive web response system (IWRS) will be used for randomization. Considering the relatively small expected enrollment at each study site, and to ensure balanced allocation of participants between the two treatment groups within each stratification level and each center, a variable block randomization method with block sizes of 4 and 6 will be adopted. Participants will be randomly assigned in a 1:1 ratio to either the experimental group (stepwise TIPS using a controlled expandable stent system) or the control group (standard diameter group). Stratification factors include: (1) Liver functional reserve: Child-Pugh class A vs. Child-Pugh class B/C (class C with a score < 12); (2) Center effect: stratified by study site.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

none

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

本研究中使用和分析的数据集可根据合理要求从通讯作者处获取。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

本研究原始数据采集使用病例记录表,本研究使用符合 GCP 规范的电子数据采集系统(EDC)进行数据录入与管理。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Original data collection in this study will be performed using case report forms (CRFs). An electronic data capture (EDC) system compliant with Good Clinical Practice (GCP) standards will be employed for data entry and management.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2026-05-31 20:58:47