西藏地区肝硬化食管静脉曲张破裂出血的临床特征研究  

Clinical analysis of esophageal variceal bleeding in Tibetan patients with cirrhosis

作　　者：格桑央吉 次仁央金[1] 德吉[1] 平措曲珍 格珍 Gesang Yang ji;Ciren yangjin;Deji;Pingcuo Quzhen;Gezhen(Department of Gastroenterology,People's Hospital of Xizang Autonomous Region Lhasa 850000,China)

机构地区：[1]西藏自治区人民医院消化内科,拉萨850000

出　　处：《西藏科技》2024年第12期60-66,80,共8页Xizang Science And Technology

摘　　要：目的探讨西藏地区肝硬化合并食管静脉曲张(esophageal varices,EV)患者出现食管静脉曲张破裂出血(esophageal variceal bleeding,EVB)可能的危险因素。方法选取2021年1月至2022年4月在西藏自治区人民医院消化内科住院的肝硬化患者119例,且住院期间均接受了胃镜检查,结果提示有EV的患者。住院患者分为出血组与未出血组,分析患者的临床资料,采用多因素Logistic回归分析探究肝硬化合并EVB的影响因素。结果119例患者中,男女比例为3.6:1,出血组77例(64.7%),未出血组42例(35.3%)。其中酒精性肝硬化28例(23.5%),乙肝性肝硬化78例(65.5%),其他原因性肝硬化13例(11.0%)。多因素Logistic回归分析结果显示:年龄(OR=1.058,95%CI=1.001~1.118)、既往有无出血史(OR=7.524,95%CI=1.189~47.598)、Child-Pugh分级(OR=6.211,95%CI=1.852~20.836)、血红蛋白(Hb)(OR=15.034,95%CI=3.407~66.347)、活化部分凝血酶原时间(APTT)(OR=0.148,95%CI=0.029~0.767)、天门冬氨酸氨基转移酶(AST)(OR=0.168,95%CI=0.033~0.860)、EV程度(OR=4.792,95%CI=1.331~17.249)是肝硬化EVB的独立影响因素。结论年龄、既往有出血史、Child-Pugh分级、Hb、EV程度为西藏地区肝硬化患者出现EVB的独立危险因素,而APTT、AST为保护性因素。Objective To investigate the risk factors of esophageal variceal bleeding(EVB)in Tibetan patients with cirrhosis.Methods A total of 119 patients with cirrhosis and esophageal varices(EV)who were hospitalized in the Department of Gastroenterology of the People’s Hospital of Xizang Autonomous Region from January 2021 to April 2022 were selected and divided into bleeding group and non-bleeding group.The clinical data of the patients were analyzed.The influencing factors of cirrhosis complicated with EVB were explored by multivariate Logistic regression analysis.Results Among the 119 patients,the male to female ratio was 3.6:1,with 77 cases(64.7%)in the bleeding group and 42 cases(35.3%)in the non-bleeding group.Among them,there were 28 cases(23.5%)of alcoholic cirrhosis,78 cases(65.5%)of hepatitis B cirrhosis,and 13 cases(11.0%)of other causes of cirrhosis.The results of multivariate Logistic regression analysis showed that age(OR=1.058,95%CI=1.001~1.118),history of bleed-ing(OR=7.524,95%CI=1.189~47.598),Child-Pugh grade(OR=6.211,95%CI=1.852~20.836),Hb(OR=15.034,95%CI=3.407~66.347),activated partial prothrombin time(APTT)(OR=0.148,95%CI=0.029~0.767),Aspartate aminotransferase(AST)(OR=0.168,95%CI=0.033~0.860)and degree of EV(OR=4.792,95%CI=1.331~17.249)were the independent factors for EVB in cirrhosis.Conclusion Age,previous bleeding history,Child-Pugh grade,Hb and EV severity were independent risk factors for EVB in patients with cirrhosis in Xizang,while APTT and AST were protective factors.

关 键 词：西藏 肝硬化 食管静脉曲张出血 危险因素 

分 类 号：R57[医药卫生—消化系统]