肝硬化并发上消化道出血相关危险因素分析

目的探讨肝硬化并发上消化性出血的相关危险因素。方法选择2011年12月-2013年12月住院的肝硬化患者252例进行病例对照研究,按其是否合并出血分为2组,出血组120例,未出血组132例。统计2组性别、年龄、血常规及生化结果、凝血功能、影像学结果、胃镜结果、肝功能Child-Pugh评分和HP感染等因素,进行单因素分析和多因素非条件Logistic回归分析,以了解肝硬化并发上消化道出血的相关危险因素。结果 单因素分析结果显示,2组食管静脉曲张程度、消化性溃疡、肝功能Child-Pugh评分、腹水情况、胃左静脉内径、血红蛋白、白蛋白、凝血酶原时间(PT)>16 s等差异有统计学意义(P<0.05),而HP感染情况无明显差异(P>0.05)。多因素非条件Logistic回归分析显示:腹水(OR=4.54,95%CI 2.73⁷.54,P=0.01)、胃左静脉内径(OR=1.53,95%C11.017.54,P=0.01)、胃左静脉内径(OR=1.53,95%C11.01².30,P=O.04)、PT>16 s(OR=2.15,95%CI 1.512.30,P=O.04)、PT>16 s(OR=2.15,95%CI 1.51³.06,P=0.01)和食管静脉曲张程度(OR=9.06,95%CI4.963.06,P=0.01)和食管静脉曲张程度(OR=9.06,95%CI4.96¹6.57,P=0.01)是肝硬化并发上消化道出血的相关危险因素。结论肝硬化并发上消化道出血的危险因素包括腹水、胃左静脉内径、PT>16 s和食管胃静脉曲张。

Risk factors analysis of cirrhosis with gastrointestinal bleeding

Objective To evaluate the related risk factors of cirrhosis with gastrointestinal bleeding.Methods Selected hospitalized 252 cases with cirrhotic from December 2011 to December 2013 for conducted this case-control study,according to whether hemorrhage,they were divided into two groups,120 cases of hemorrhage group,132 cases are not bleeding group.Calculated 2 groups＇ gender,age,blood and biochemical results,coagulation,imaging results,endoscopy results of liver function Child-Pugh score and HP infection and other factors,univariate analysis and multivariate Logistic regression analysis were performed to understand the risk factors associated with cirrhosis of gastrointestinal bleeding.Results Univariate analysis showed that two groups of esophageal varices,peptic ulcer,liver function Child-Pugh score,ascites,the left gastric vein diameter,hemoglobin,albumin,PT〉 16 s revealed differences,the difference was statistically significant（P〈0.05）,whereas no significant difference in HP infection（P〉 0.05）.Multivariate Logistic regression analysis showed that：ascites（OR =4.54,95%CI 2.73-7.54,P =0.01）,left gastric vein diameter（OR = 1.53,95%CI 1.01-2.30,P =0.04）,PT〉16 s（OR =2.15,95%CI 1.51-3.06,P =0.01） and the degree of esophageal varices（OR =9.06,95%CI 4.96-16.57,P =0.01） was digested on cirrhosis Road-related risk factors for bleeding.Conclusion The risk factors of cirrhosis with gastrointestinal bleeding included esophageal varices,ascites,the diameter of left gastric vein and PT 〉16 s.