Logistic回归分析食管静脉曲张破裂出血的危险因素*

目的 探讨与肝硬化食管静脉曲张破裂出血（EVB）相关的危险因素，寻找一种有效预测EVB发生的无创检测指标。方法 回顾性分析168例肝硬化患者的临床资料，其中出血85例，非出血83例，对可能影响EVB发生的临床指标进行分析，将有显著性差异的因素进行单因素Logistic回归分析，然后对两组中有统计学意义的因素进行多因素非条件Logistic回归分析。结果 两组患者性别、年龄、病因分布差异均无统计学意义（P＞0.05）；出血患者门静脉直径（DPV）、脾静脉直径（DSV）和脾脏指数（SI）分别为（1.48±0.28） cm、（1.08±0.19） cm和（72.54±16.69）cm2，显著高于非出血组分别为（1.34±0.29） cm、（1.18±0.25） cm和（66.98±19.21） cm2，P＜0.05]；出血患者血Na+和血小板/脾长径比值分别为（139.45±3.41） mmol/L和（5.05±2.07）×109/L?cm-1，显著低于非出血组分别为（140.66±4.41） mmol/L和（8.99±4.36）×109/L?cm-1，P＜0.05]；出血组Child-Pugh分级与非出血组比较，差异有统计学意义（P＜0.05）；单因素Logistic回归分析显示两组间DPV、DSV、血小板计数与脾脏长径比值和Child-Pugh分级差异均有统计学意义（OR值分别为6.832、7.283、0.655、2.129，P＜0.05），多因素非条件Logistic回归分析显示血小板计数与脾脏长径比值（OR=0.685，P=0.000）是肝硬化患者发生EVB的独立危险因素。结论 血小板计数与脾脏长径比值可作为肝硬化患者发生EVB的无创预测指标。

Logistic regression analysis on risk factors of esophageal variceal bleeding in patients with uncompensated liver cirrhosis

Objective To discuss the related risk factors of esophageal variceal bleeding（EVB）in patients with liver cirrhosis and to find out an effective noninvasive index for predicting EVB. Methods A retrospective analysis of clinical data of 168 patients with liver cirrhosis were carried out，and 85 patients with and 83 without EVB were included. The clinical data that may affect the EVB were analyzed by Logistic regression analysis. Results The age，gender and causses of liver cirrhosis in the two groups had no statistically significant difference （P＞0.05）；The diameter of portal vein （DPV），diameter of splenic vein （DSV） and splenic index （SI） in patients with EVB were （1.48±0.28）cm，（1.08±0.19）cm and （72.54±16.69） cm2，respectively，significantly higher than those in without （1.34±0.29）cm，（1.18±0.25）cm and （66.98±19.21） cm2，respectively，P＜0.05]；Serum Na＋ and ratio of platelet counts/splenic length in patients with EVB were （139.45±3.41）mmol/L and（5.05±2.07）×109/L?cm-1，respectively，significantly lower than in without （140.66±4.41） mmol/L and（8.99±4.36）×109/L?cm-1，respectively，P＜0.05]；The Child-Pugh class between the two groups was significantly different（P＜0.05）；Logistic regression analysis showed that DPV，DSV，ratio of platelet counts/splenic length and Child-Pugh classification between the two groups were statistically significant（OR=6.832，7.283，0.655，2.129，respectively，P＜0.05），and multivariate and unconditioned Logistic regression analysis showed that only ratio of platelet counts/splenic length （OR=0.685，P=0.000）was an independent risk factor for EVB in patients with cirrhosis. Conclusion Ratio of platelet counts/splenic length might be used as an predictive index for EVB in patients with cirrhosis．