肝硬化食管胃底静脉曲张破裂出血后肝静脉压力梯度的影响因素分析  

Analysis on influential factors of hepatic venous pressure gradient after esophagogastric variceal bleeding in liver cirrhosis

作　　者：申力军[1] 丁鹏鹏 韩晶晶[1] 祁小宝 马宇茗 马雪梅[1] 吴勤[1] 吴立兵[1] 楚金东[1] 于晓莉[1] 毕茜 张文辉[1] 金波[1] 李捍卫[1] SHEN Li-jun;DING Peng-peng;HAN Jing-jing;QI Xiao-bao;MA Yu-ming;MA Xue-mei;WU Qin;WU Li-bing;CHU Jin-dong;YU Xiao-li;BI Qian;ZHANG Wen-hui;JIN Bo;LI Han-wei(First Liver Cirrhosis Diagnosis and Treatment Center,302 Military Hospital of China,Beijing 100039,China)

机构地区：[1]解放军第三〇二医院肝硬化诊疗一中心,北京100039 [2]解放军第三〇二医院肝衰竭诊疗与研究中心血液净化科,北京100039

出　　处：《传染病信息》2018年第2期140-144,共5页Infectious Disease Information

基　　金："十二五"国家科技重大专项艾滋病和病毒性肝炎等重大传染病防治子课题(2013ZX10002001-001-003);北京市科技新星项目(Z161100004916170)

摘　　要：目的探讨肝硬化食管胃底静脉曲张破裂出血(esophagogastric variceal bleeding,EVB)后肝静脉压力梯度(hepatic venous pressure gradient,HVPG)的影响因素。方法选择2015年1月—2017年7月在我院诊治的肝硬化EVB患者178例,回顾性分析临床资料与HVPG的关系。结果肝硬化EVB后HVPG中位数为16.9 mm Hg(1 mm Hg=0.133 k Pa);病毒性肝硬化患者HVPG低于非病毒性肝硬化患者,存在非常见侧支循环(uncommon portosystemic collateral circulations,UPCC)、EVB次数>3次患者伴有较低HVPG,高血糖、低白蛋白症、贫血及肝细胞癌患者伴有较高HVPG,差异均有统计学意义(P均<0.05);多元线性回归分析显示肝硬化病因、糖化血红蛋白水平、EVB次数及UPCC对HVPG有较大影响。结论肝硬化患者EVB后HVPG仍高于正常水平;肝硬化病因、糖化血红蛋白水平、EVB次数及UPCC是影响HVPG的重要因素。Corresponding author.LI Han-wei,E-mail:[e-mail];JIN Bo,E-mail:[e-mail] [Abstract] Objective To explorer the influential factors of hepatic venous pressure gradient(HVPG)after esophagogastric variceal bleeding(EVB)in liver cirrhosis.Methods The medical history and clinical data of 178 patients with liver cirrhosis who underwent EVB and their correlation with HVPG measurement in our hospital from January 2015 to July 2017 were retrospectively analyzed.Results The average HVPG value of liver cirrhosis patients who underwent EVB was 16.9 mmHg(1 mmHg=0.133 kPa).HVPG value of viral cirrhosis patients was lower than that of non-viral cirrhosis patients.Patients who had uncommon portosystemic collateral circulations(UPCC)or underwent EVB for more than 3 times might have lower HVPG,while those who had hyperalycemia,hypoalbuminemia,anemia or hepatocellular carcinoma might have higher HVPG,with significant difference(P<0.05).Multivariant linear regression analysis showed that etiology of cirrhosis,glycosylated hemoglobin level,times of EVB and UPCC could greatly influence HVPG in liver cirrhosis patients after EVB.Conclusions HVPG value increases in liver cirrhosis patients who underwent EVB,and etiology of cirrhosis,glycosylated hemoglobin level,times of EVB and UPCC are regarded the influential factors of HVPG.

关 键 词：肝硬化 食管胃底静脉曲张破裂出血 肝静脉压力梯度 影响因素 

分 类 号：R575.2[医药卫生—消化系统] R364.13[医药卫生—内科学]