肝硬化食管静脉曲张出血相关因素的分析  

Related factors analysis of cirrhosis with esophageal variceal bleeding

作　　者：王敏[1] 张倩倩[1] 许建明[1] 孔德润[1] 

机构地区：[1]安徽医科大学第一附属医院消化内科,合肥230022

出　　处：《安徽医学》2012年第6期649-651,共3页Anhui Medical Journal

基　　金：国家自然科学基金项目(项目编号:81070337)

摘　　要：目的肝硬化并发食管静脉曲张患者发生静脉破裂出血风险大,预后不同。本研究旨在探讨肝硬化并发食管静脉曲张破裂出血及其控制出血的相关因素。方法收集肝硬化食管静脉曲张患者272例,回顾性分析其临床资料。通过单因素分析,分析临床各项指标及内镜指标与出血的关系;Logistic回归分析出血的预测因素。针对出血组通过单因素分析,分析临床各项指标及内镜指标与控制出血成功与否的关系。结果 272例肝硬化食管静脉曲张患者中,113例(41.54%)合并出血,159例(58.46%)未发生出血。单因素分析显示:出血组和非出血组在凝血酶原活动度(PTA)、国际标准化比值(INR)、终末期肝病模型(MELD)评分、感染、曲张静脉的美国分级、红色征比较差异具有统计学意义(P<0.05);Logistic回归分析显示国际标准化比值(INR)和红色征是出血的预测因素。控制出血成功组与失败组在肝功能CTP评分比较差异具有统计学意义(P<0.05)。结论国际标准化比值(INR)和红色征是肝硬化食管静脉曲张出血的预测重要参考因素,而肝功能CTP评分与控制出血成功与否有关。Objective Liver cirrhosis with esophageal varices have a high risk of bleeding and have different prognosis. This study re- searched the related factors of cirrhosis with esophageal variceal bleeding and controlling bleeding. Methods Collecting 272 cirrhosis pa- tients with esophageal varices, the clinical data were analyzed retrospectively.Through the single factor analysis, the relations between the clini- cal and endoscopic index and bleeding were analyzed. Logistic regression analyzed the predictors of bleeding.Also, through the single factor analysis, the relations between the clinical and endoscopic index and controlling bleeding were analyzed about hemorrhage group. Results In 272 cirrhosis patients with esophageal varices, 113 cases （41.54%） were bleeding, 159 cases （58.46%） had not occurred. Single factor analy- sis shows that prothrombin activity （PTA）, international standardization ratio （INR）, Model for End-stage Liver Disease（MELD） score , infec- tion, the United States classification of varicosis vein, and red wale mark between the bleeding group and non-bleeding group had significant difference （P〈0.05）; Logistic regression analysis showed that the international standardization ratio （INR） and red wale mark were prediction factors of bleeding. Between the success group to control bleeding and the failure group, Child-Turcotte-Pugh （CTP）had significant difference （P〈 0.05 ）. Conclusion The international standardization ratio （INR） and red wale mark is the predictors of liver cirrhosis with esophageal varieeal bleeding, and controlling bleeding was related to Child-Turcotte-Pugh （CTP）.

关 键 词：肝硬化 食管静脉曲张出血 预测因素 控制出血 

分 类 号：R575.2[医药卫生—消化系统]