中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2013年
2期
71-74
,共4页
杨少奇%刘云霞%闪明海%杨力
楊少奇%劉雲霞%閃明海%楊力
양소기%류운하%섬명해%양력
食管胃静脉曲张出血%肝硬化%危险因素
食管胃靜脈麯張齣血%肝硬化%危險因素
식관위정맥곡장출혈%간경화%위험인소
Esophageal varices hemorrhage%Liver cirrhosis%Risk factors
目的 初步探讨可以评估肝硬化患者食管胃静脉曲张破裂出血风险的临床指标.方法 回顾性总结286例合并食管胃静脉曲张破裂出血的肝硬化患者(观察组)及352例未发生出血的肝硬化患者(对照组)的临床资料,对2组间存在差异性的指标运用单因素和多因素Logistic回归模型进行分析.结果 2组在肝功能分级状况(P＜0.05)、白蛋白(t=5.05,P=0.000)、凝血酶原时间(t=-2.80,P=0.005)、门静脉内径(t=-2.28,P=0.006)、脾厚度(t=-2.73,P=0.006)方面差异有统计学意义.单因素非条件Logistic回归分析显示白蛋白(OR=0.944,P=0.000)、凝血酶原时间(OR=1.067,P=0.007)、门静脉内径(OR=3.423,P=0.007)、脾厚度(OR=1.276,P=0.007)与出血存在相关性,进一步多因素非条件Logistic回归分析提示白蛋白(OR=0.936,P=0.000)、门静脉内径(OR=4.098,P=0.013)、脾厚度(OR=1.275,P=0.000)是出血的独立危险因素.结论 白蛋白、门静脉内径、脾厚度是肝硬化并发食管胃静脉曲张破裂出血的独立危险因素,对预测食管胃静脉曲张破裂出血的发生有重要的临床价值,改善白蛋白可在一定程度上减少肝硬化并发食管胃静脉曲张破裂出血的风险.
目的 初步探討可以評估肝硬化患者食管胃靜脈麯張破裂齣血風險的臨床指標.方法 迴顧性總結286例閤併食管胃靜脈麯張破裂齣血的肝硬化患者(觀察組)及352例未髮生齣血的肝硬化患者(對照組)的臨床資料,對2組間存在差異性的指標運用單因素和多因素Logistic迴歸模型進行分析.結果 2組在肝功能分級狀況(P＜0.05)、白蛋白(t=5.05,P=0.000)、凝血酶原時間(t=-2.80,P=0.005)、門靜脈內徑(t=-2.28,P=0.006)、脾厚度(t=-2.73,P=0.006)方麵差異有統計學意義.單因素非條件Logistic迴歸分析顯示白蛋白(OR=0.944,P=0.000)、凝血酶原時間(OR=1.067,P=0.007)、門靜脈內徑(OR=3.423,P=0.007)、脾厚度(OR=1.276,P=0.007)與齣血存在相關性,進一步多因素非條件Logistic迴歸分析提示白蛋白(OR=0.936,P=0.000)、門靜脈內徑(OR=4.098,P=0.013)、脾厚度(OR=1.275,P=0.000)是齣血的獨立危險因素.結論 白蛋白、門靜脈內徑、脾厚度是肝硬化併髮食管胃靜脈麯張破裂齣血的獨立危險因素,對預測食管胃靜脈麯張破裂齣血的髮生有重要的臨床價值,改善白蛋白可在一定程度上減少肝硬化併髮食管胃靜脈麯張破裂齣血的風險.
목적 초보탐토가이평고간경화환자식관위정맥곡장파렬출혈풍험적림상지표.방법 회고성총결286례합병식관위정맥곡장파렬출혈적간경화환자(관찰조)급352례미발생출혈적간경화환자(대조조)적림상자료,대2조간존재차이성적지표운용단인소화다인소Logistic회귀모형진행분석.결과 2조재간공능분급상황(P＜0.05)、백단백(t=5.05,P=0.000)、응혈매원시간(t=-2.80,P=0.005)、문정맥내경(t=-2.28,P=0.006)、비후도(t=-2.73,P=0.006)방면차이유통계학의의.단인소비조건Logistic회귀분석현시백단백(OR=0.944,P=0.000)、응혈매원시간(OR=1.067,P=0.007)、문정맥내경(OR=3.423,P=0.007)、비후도(OR=1.276,P=0.007)여출혈존재상관성,진일보다인소비조건Logistic회귀분석제시백단백(OR=0.936,P=0.000)、문정맥내경(OR=4.098,P=0.013)、비후도(OR=1.275,P=0.000)시출혈적독립위험인소.결론 백단백、문정맥내경、비후도시간경화병발식관위정맥곡장파렬출혈적독립위험인소,대예측식관위정맥곡장파렬출혈적발생유중요적림상개치,개선백단백가재일정정도상감소간경화병발식관위정맥곡장파렬출혈적풍험.
Objective To analyze the risk factors of esophageal and gastric variceal bleeding (EGVB) in patients with cirrhosis.Methods A retrospective study was conducted in 638 hospitalized patients with cirrhosis from 2002 to 2009,who were divided into study group as having EGVB (n =286) and control group as not having EGVB (n =352).Differences between 2 groups were analyzed with univariate analysis and multivariate logistic regression.Results Child-pugh classification,serum albumin,prothrombin time,portal vein diameter and spleen thickness were significantly different between 2 groups (P ＜ 0.05).Univariate analysis showed that serum albumin(OR =0.944,P =0.000),prothrombin time (OR =1.067,P =0.007),portal vein diameter (OR =3.423,P =0.007) and spleen thickness (OR =1.276,P =0.007) were correlated with EGVB.Multivariate logistic regression analysis showed that serum albumin (OR =0.936,P =0.000),portal vein diameter (OR =4.098,P =0.013) and spleen thickness (OR =1.275,P =0.000) were independent risk factors for EGVB in patients with cirrhosis.Conclusion Low serum albumin level,increased portal vein diameter and spleen thickness are the risk factors for EGVB in patients with cirrhosis,which can be important predictors.To some extent,increasing serum albumin might reduce the risk of EGVB.
