CAJ | 학술논문

目的：探讨肝硬化并发上消化性出血的相关危险因素。方法选择2011年12月-2013年12月住院的肝硬化患者252例进行病例对照研究，按其是否合并出血分为2组，出血组120例，未出血组132例。统计2组性别、年龄、血常规及生化结果、凝血功能、影像学结果、胃镜结果、肝功能Child-Pugh评分和HP感染等因素，进行单因素分析和多因素非条件Logistic回归分析，以了解肝硬化并发上消化道出血的相关危险因素。结果单因素分析结果显示，2组食管静脉曲张程度、消化性溃疡、肝功能Child-Pugh评分、腹水情况、胃左静脉内径、血红蛋白、白蛋白、凝血酶原时间（PT）＞16 s等差异有统计学意义（ P ＜0．05），而HP感染情况无明显差异（ P ＞0．05）。多因素非条件Logistic回归分析显示：腹水（OR＝4．54，95％CI 2．73～7．54， P ＝0．01）、胃左静脉内径（OR＝1．53，95％ CI 1．01～2．30， P ＝0．04）、PT＞16 s（OR＝2．15，95％ CI 1．51～3．06， P ＝0．01）和食管静脉曲张程度（OR＝9．06，95％ CI 4．96～16．57， P ＝0．01）是肝硬化并发上消化道出血的相关危险因素。结论肝硬化并发上消化道出血的危险因素包括腹水、胃左静脉内径、PT＞16 s和食管胃静脉曲张。
목적：탐토간경화병발상소화성출혈적상관위험인소。방법선택2011년12월-2013년12월주원적간경화환자252례진행병례대조연구，안기시부합병출혈분위2조，출혈조120례，미출혈조132례。통계2조성별、년령、혈상규급생화결과、응혈공능、영상학결과、위경결과、간공능Child-Pugh평분화HP감염등인소，진행단인소분석화다인소비조건Logistic회귀분석，이료해간경화병발상소화도출혈적상관위험인소。결과단인소분석결과현시，2조식관정맥곡장정도、소화성궤양、간공능Child-Pugh평분、복수정황、위좌정맥내경、혈홍단백、백단백、응혈매원시간（PT）＞16 s등차이유통계학의의（ P ＜0．05），이HP감염정황무명현차이（ P ＞0．05）。다인소비조건Logistic회귀분석현시：복수（OR＝4．54，95％CI 2．73～7．54， P ＝0．01）、위좌정맥내경（OR＝1．53，95％ CI 1．01～2．30， P ＝0．04）、PT＞16 s（OR＝2．15，95％ CI 1．51～3．06， P ＝0．01）화식관정맥곡장정도（OR＝9．06，95％ CI 4．96～16．57， P ＝0．01）시간경화병발상소화도출혈적상관위험인소。결론간경화병발상소화도출혈적위험인소포괄복수、위좌정맥내경、PT＞16 s화식관위정맥곡장。
Objective To evaluate the related risk factors of cirrhosis with gastrointestinal bleeding .Methods Se-lected hospitalized 252 cases with cirrhotic from December 2011 to December 2013 for conducted this case-control study , ac-cording to whether hemorrhage , they were divided into two groups , 120 cases of hemorrhage group , 132 cases are not bleeding group.Calculated 2 groups'gender, age, blood and biochemical results , coagulation, imaging results, endoscopy results of liver function Child-Pugh score and HP infection and other factors , univariate analysis and multivariate Logistic regression a-nalysis were performed to understand the risk factors associated with cirrhosis of gastrointestinal bleeding .Results Univariate analysis showed that two groups of esophageal varices , peptic ulcer, liver function Child-Pugh score, ascites, the left gastric vein diameter, hemoglobin, albumin , PT>16 s revealed differences, the difference was statistically significant ( P <0.05), whereas no significant difference in HP infection ( P >0.05).Multivariate Logistic regression analysis showed that: ascites (OR=4.54, 95%CI 2.73-7.54, P =0.01), left gastric vein diameter (OR=1.53, 95%CI 1.01-2.30, P =0.04), PT>16 s (OR=2.15,95%CI 1.51-3.06, P =0.01) and the degree of esophageal varices (OR=9.06, 95%CI 4.96-16.57, P =0.01) was digested on cirrhosis Road -related risk factors for bleeding.Conclusion The risk factors of cirrhosis with gastrointestinal bleeding included esophageal varices , ascites, the diameter of left gastric vein and PT >16 s.