肝硬化食管静脉曲张破裂出血的危险因素  

Risk factors for esophageal variceal bleeding in patients with liver cirrhosis

作　　者：张海平[1] 林军[1] 

机构地区：[1]武汉大学中南医院消化内科,湖北省武汉市430071

出　　处：《世界华人消化杂志》2014年第32期4991-4995,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨肝硬化食管静脉曲张破裂出血(esophageal varices bleeding,EVB)的危险因素.方法:回顾性分析178例肝硬化食管静脉曲张患者的临床资料,其中出血组118例,未出血组60例;分别统计2组24个指标,通过t检验、χ2检验和多因素非条件Logistic回归分析得出肝硬化EVB的危险因素.结果:出血组与未出血组之间红细胞计数、血红蛋白、血清白蛋白、凝血酶原活动度、肝功能Child B级、肝功能Child C级、既往E V B史、门静脉内径、脾静脉内径、脾脏厚度、红色征差异有统计学意义.多因素非条件Logistic回归分析结果提示血红蛋白(OR=0.204,P=0.001)、血清白蛋白(O R=0.126,P=0.000)与E V B风险呈负相关,既往E V B史(OR=3.622,P=0.01)、门静脉内径(OR=2.619,P=0.032)、红色征(OR=4.647,P=0.001)与EVB风险呈正相关.结论:贫血、低蛋白血症、既往EVB史、门静脉内径增宽、红色征阳性是EVB的独立危险因素.AIM： To investigate risk factors for esophageal variceal bleeding （EVB） in patients with liver cir- rhosis. METHODS： Clinical data for 178 esophageal varices patients with liver cirrhosis were ana- lyzed retrospectively. The patients were divided into either an EVB group （n -- 118） or a non-EVB group （n = 60）. Twenty-four potential factors were analyzed by t-test, chi-square test and mul- tivariate Logistic regression analysis to identify the risk factors for EVB. RESULTS： Red blood cell （RBC） count, hemo- globin （Hb）, albumin （ALB）, prothrombin time activity （PTA）, Child-Pugh class B and C hepatic function, history of EVB, portal vein width, splenic vein width, splenic thickness, and red- color sign demonstrated statistically significant differences between the EVB group and the non- EVB group. Multivariate Logistic regressionanalysis showed and Hb （OR = 0.204, P = 0.001） and ALB （OR = 0.126, P = 0.000） were correlated negatively with EVB, while history of EVB （OR = 3.622, P = 0.01）, portal vein width （OR = 2.619, P = 0.032） and red-color sign （OR = 4.647, P = 0.001） were correlated positively with EVB.CONCLUSION： Anemia, hypoalbuminemia, history of EVB, extended portal vein width, and positive red-color sign are independent risk fac- tors for EVB

关 键 词：贫血 低蛋白血症 既往EVB史 门静脉内径增宽 红色征阳性是EVB的独立危险因素 

分 类 号：R575.2[医药卫生—消化系统]