肝硬化上消化道出血患者并发肝性脑病的危险因素分析  

Analysis of risk factors for hepatic encephalopathy in patients with liver cirrhosis with upper gastrointestinal bleeding

作　　者：张飞[1] 刘斌 施彦卿 吴时胜 ZHANG Fei;LIU Bin;SHI Yan-qing;WU Shi-sheng(Department of Gastroenterology,The Second People's Hospital of Huangshi,Hubei,Huangshi 435000,China;Department of Gastroenterology,North China University of Science and Technology,Hebei ,Tangs-han 063000,China;Department of Gastroenterology,Affilated Hospital of Jiujiang University,Jiangxi ,Jiu-jiang 332000,China)

机构地区：[1]黄石市第二医院消化内科,湖北黄石435000 [2]华北理工大学附属医院消化内科,河北唐山063000 [3]九江学院附属医院消化内科,江西九江332000

出　　处：《中国中西医结合消化杂志》2018年第11期934-937,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：中国肝炎防治基金会资助项目(No:TQGB20170015)

摘　　要：[目的]探讨肝硬化上消化道出血患者并发肝性脑病的危险因素,为临床早期干预提供依据。[方法]选取肝硬化并发上消化道出血患者235例,依据是否并发肝性脑病,分为病例组(并发肝性脑病组)93例,对照组(没有并发肝性脑病组)142例。对2组患者的临床资料采用单因素和多因素非条件Logistic回归进行统计学分析,筛选出肝硬化上消化道出血患者并发肝性脑病的危险因素。[结果]单因素分析结果显示:病例组和对照组在WBC、PLT、ALT、ALB、TBIL、BUN、Scr、Na+、AM、PT、肝功能CTP评分、腹水、感染方面比较,P<0.05,差异有统计学意义;多因素非条件Logistic回归分析结果显示:血氨增加(OR=1.237,P=0.042)、肝功能CTP评分增加(OR=1.328,P=0.027)、血肌酐增加(OR=2.427,P=0.039)、腹水增多(OR=1.546,P=0.034)是硬化上消化道出血患者并发肝性脑病的危险因素。[结论]更高的血氨、更高的肝功能CTP评分、更高的血肌酐、更多的腹水是硬化上消化道出血患者并发肝性脑病的独立危险因素。[Objective] To explore the risk factors of hepatic encephalopathy in patients with upper gastrointestinal hemorrhage due to cirrhosis and to provide evidence for early clinical intervention.[Methods]235 patients with liver cirrhosis complicated with upper gastrointestinal bleeding were divided into case group(hepatic encephalopathy group)93 cases and control group(no hepatic encephalopathy group)142 cases.[Results]Univariate analysis showed that there were significant differences in WBC,PLT,ALT,ALB,TBIL,BUN,Scr,Na+,AM,PT,liver function CTP score,ascites and infection between the two groups(P<0.05).Multivariate unconditional logistic regression analysis showed that increased serum ammonia(OR=1.237,P=0.042),increased liver function CTP score(OR=1.328,P=0.027),increased serum creatinine(OR=2.427,P=0.039),and increased ascites(OR=1.546,P=0.034)were risk factors for hepatic encephalopathy in patients with upper gastrointestinal hemorrhage due to cirrhosis.[Conclusion]Higher serum ammonia,higher liver function CTP score,higher serum creatinine and more ascites are independentrisk factors for hepatic encephalopathy in patients with upper gastrointestinal hemorrhage due to cirrhosis.

关 键 词：肝硬化 上消化道出血 肝性脑病 危险因素 

分 类 号：R575.2[医药卫生—消化系统]