肝硬化并发上消化道出血的危险因素分析  

Analysis of Risk Factors of Liver Cirrhosis Complicated with Upper Gastrointestinal Bleeding

作　　者：信红月 孙月婷 郝贺 阎雪 XIN Hongyue;SUN Yueting;HAO He;YAN Xue(The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第一医院,辽宁锦州121000

出　　处：《锦州医科大学学报》2025年第1期65-69,共5页Journal of Jinzhou Medical University

基　　金：辽宁省教育科学“十四五”规划项目,项目编号:JG22DB263。

摘　　要：目的通过非侵入性检查分析探讨肝硬化并发上消化道出血的危险因素。方法收集锦州医科大学附属第一医院2021年3月至2023年6月诊断并治疗的262例乙型病毒性、丙型病毒性和酒精性肝硬化患者的临床数据信息,分为出血组(肝硬化合并上消化道出血,n=140)和未出血组(肝硬化,n=122)。收集上述患者的年龄、性别、病因、主要入院症状、肝功能Child-Pugh评分、凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,Fib)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、血小板计数(platele,PLT)等数据,采用单因素分析和多因素Logistic回归分析寻找肝硬化并发上消化道出血的影响因素。结果出血组和未出血组患者的单因素分析比较:年龄、性别、病因,差异无统计学意义(P>0.05);主要入院症状中乏力,差异无统计学意义(P>0.05);血清学指标ALT、AST、PLT,差异无统计学意义(P>0.05);出血组患者肝功能Child-Pugh评分高于未出血组,差异有统计学意义(P<0.05);主要入院症状中未出血组患者腹胀、黄疸明显多于出血组,差异有统计学意义(P<0.05);血清学指标出血组PT值明显高于未出血组、Fib水平明显低于未出血组,差异有统计学意义(P<0.05)。多因素分析比较肝功能Child-Pugh评分、PT、Fib:肝功能Child-Pugh评分、PT为影响肝硬化上消化道出血的危险因素(OR=1.583、1.432),差异有统计学意义(P<0.05);Fib为影响肝硬化上消化道出血的保护性因素(OR=0.235),差异有统计学意义(P<0.05)。结论肝硬化上消化道出血患者的肝功能Child-Pugh评分、PT为危险因素,Fib为保护性因素。Objective To analyze and discuss the risk factors of upper gastrointestinal bleeding in liver cirrhosis by non-invasive examination.Methods Clinical data of 262 patients with hepatitis B,hepatitis C and alcoholic cirrhosis admitted and treated in our hospital from March 2021 to June 2023 were collected and divided into bleeding group(cirrhosis complicated with upper digestive tract hemorrhage,n=140)and non-bleeding group(cirrhosis,n=122).Data such as Age,gender,etiology,main admission symptoms,liver function Child-Pugh score,prothrombin time(PT),fibrinogen(Fib),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and platele(PLT)and other data of the patients were collected.Univariate analysis and multiple Logistic regression analysis were used to find the influential factors of cirrhosis complicated with upper gastrointestinal bleeding.Results Univariate analysis showed that there was no significant difference in age,sex and etiology between the bleeding group and the non-bleeding group(P>0.05);there was no significant difference in fatigue among the main admission symptoms(P>0.05);there was no significant difference in serum indexes ALT,AST and PLT(P>0.05);the Child-Pugh score of liver function in bleeding group was higher than that in non-bleeding group,and the difference was statistically significant(P<0.05);among the main admission symptoms,abdominal distension and jaundice in the non-bleeding group were significantly higher than those in the bleeding group,with statistical significance(P<0.05);the serum index of bleeding group was significantly higher than that of non-bleeding group,and the level of Fib was significantly lower than that of non-bleeding group,with statistical significance(P<0.05).The Child-Pugh score,PT and Fib of liver function were compared by multivariate analysis:Child-Pugh score of liver function and PT were the risk factors for upper gastrointestinal bleeding in liver cirrhosis(OR=1.583,1.432),and the difference was statistically significant(P<0.05);Fib was a protective factor

关 键 词：肝硬化 上消化道出血 危险因素 

分 类 号：R575.2[医药卫生—消化系统]