乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者临床特征及影响因素分析

doi:10.3969/j.issn.1672-5069.2021.03.023

摘要/Abstract

摘要： 目的探讨乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者的临床特征及其影响因素。方法 2015年6月～2020年6月我院收治的乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者90例和同期乙型肝炎肝硬化未出血患者90例,收集患者临床资料,分析乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者的临床特征,并采用多因素Logistic回归分析影响出血的因素。结果单因素分析结果显示,出血组病程长、有消化道出血史、使用非甾体类药物、Child-Pugh分级差、食管静脉曲张程度严重、胃左静脉内径和门静脉内径宽、PT延长、有腹水和血清白蛋白水平低与未出血组比,存在显著性统计学差异(P<0.05);多因素Logistic回归分析结果显示,肝硬化病程长、应用非甾体类药物、Child-Pugh分级差、食管静脉曲张程度严重、胃左静脉内径增宽、门静脉内径增宽、PT延长和有腹水是乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血的独立危险因素(OR=3.145;3.171;2.190;2.672;2.363;3.142;3.083;3.062,P<0.05),而血清白蛋白增加是出血的保护因素(OR=0.288,P<0.05)。结论乙型肝炎肝硬化并发食管胃底静脉曲张患者存在一些可能诱发曲张静脉破裂出血的危险因素,临床应予以重视,以预防曲张静脉破裂出血的发生。

关键词: 肝硬化, 食管胃底静脉曲张破裂出血, 临床特征, 影响因素

Abstract: Objective The aim of this study was to explore the clinical feature and impacting factors of esophageal and gastric variceal bleeding in patients with hepatitis B-induced liver cirrhosis (LC).Methods The clinical materials in 90 patients with hepatitis B cirrhosis and esophageal and gastric variceal bleeding and in 90 hepatitis with hepatitis B liver cirrhosis and varices were retrospectively analyzed. The impacting factors of variceal bleeding were analyzed by univariate multivariate Logistic regression.Results The univariate analysis showed that the long course of cirrhosis, history of variceal bleeding, the application of non-steroidal drugs, poor Child-Pugh class, the severity of esophageal varices, the widen diameter of left gastric vein and portal vein, the prolonged PT, ascite and low serum albumin level were significantly different between the two groups (P<0.05); the multivariate Logistic regression analysis showed that the long course of cirrhosis, non-steroidal administration, poor Child-Pugh class, the severity of esophageal varices, the widen diameter of left gastric vein and portal vein, the prolonged PT and ascite were the independent risk factors for esophageal varices bleeding in patients with liver cirrhosis (OR=3.145; 3.171; 2.190; 2.672; 2.363; 3.142; 3.083; 3.062, P<0.05), while .the high serum albumin level was a protective factor for varices bleeding (OR=0.288, P<0.05).Conclusion Some factors might lead to the esophageal and gastric varices bleeding in patients with hepatitis B liver cirrhosis, which should be paid more attention to and dealing with promptly in clinical practice.

Key words: Liver cirrhosis, Esophageal and gastric variceal bleeding, Clinical features, Risk factors

高慧茹, 高会斌, 彭昭, 王璐, 霍小辉. 乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者临床特征及影响因素分析[J]. 实用肝脏病杂志, 2021, 24(3): 395-398.

Gao Huiru, Gao Huibin, Peng Zhao, et al. Clinical feature and impacting factors of esophageal and gastric variceal bleeding in patients with hepatitis B-induced liver cirrhosis[J]. Journal of Practical Hepatology, 2021, 24(3): 395-398.

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