原发性胆汁性肝硬化并发食管胃底静脉曲张破裂出血患者临床特征及预后分析

doi:10.3969/j.issn.1672-5069.2026.01.027

摘要/Abstract

摘要： 目的总结原发性胆汁性肝硬化(PBC)患者并发食管胃底静脉曲张破裂出血(EVB)的临床特征和预后。方法 2021年4月～2023年12月我院收治的106例PBC并发EVB患者,其中首次EVB 33例,再出血73例。比较两组临床特征、实验室指标、并发症和预后情况。结果首次出血组入住ICU占比显著高于再出血组(12.1%对0.0%,P=0.002),而门静脉血栓发生率显著低于后者(12.1%对32.9%,P=0.025);两组6 w病死率无显著性差异(9.1%对8.2%,P=0.881),6 w再出血率亦无显著性差异(12.1%对17.8%,P=0.460),1 a病死率无显著性差异(16.2%对17.2%,P=0.897)。结论失代偿期PBC患者可能并发EVB,或反复发作,应积极止血或内镜下止血治疗。总体预后差。

关键词: 原发性胆汁性肝硬化, 食管胃底静脉曲张破裂出血, 首次出血, 内镜治疗, 门静脉血栓, 预后

Abstract: Objective The aim of this study was to summarize clinical feature and prognosis of patients primary biliary cirrhosis (PBC) complicated with esophagogastric variceal bleeding (EVB). Methods A retrospective analysis was conducted on 106 patients with PBC and EVB, including first EVB in 33 cases and re-bleeding in 73 cases, who were admitted to our hospital between April, 2021, and December, 2023. The clinical features, laboratory indicators, complications and prognosis were analyzed. Results The ICU admission rate in the first bleeding group was significantly higher than that in re-bleeding group (12.1% vs. 0.0%, P=0.002), and the incidence of portal vein thrombosis was significantly lower than in re-bleeding group (12.1% vs. 32.9%, P=0.025); no significant differences were observed between the two groups as respect to 6-week mortality (9.1% vs. 8.2%, P =0.881), 6-week re-bleeding rate (12.1% vs. 17.8%, P=0.460), and 1-year mortality (16.2% vs. 17.2%, P=0.897). Conclusion PBC patients with decompensated liver functions might complicate EVB, and re-bleeding is very common, which should be carefully intervened with hemostasis, and even endoscopic therapy.

Key words: Primary biliary cirrhosis, Esophagogastric variceal bleeding, Re-bleeding, Portal vein thrombosis, Prognosis

周圣辉, 李琪, 丁惠国. 原发性胆汁性肝硬化并发食管胃底静脉曲张破裂出血患者临床特征及预后分析[J]. 实用肝脏病杂志, 2026, 29(1): 105-108.

Zhou Shenghui, Li Qi, Ding Huiguo. Clinical feature and prognosis of patients primary biliary cirrhosis complicated with esophagogastric variceal bleeding[J]. Journal of Practical Hepatology, 2026, 29(1): 105-108.

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