肝硬化合并上消化道出血与病人血脂水平的相关性研究

目的研究肝硬化合并上消化道出血与病人血脂水平的相关性。方法回顾性分析205例肝硬化病人一般资料，根据病人有无合并上消化道出血分为观察组（肝硬化合并上消化道出血，82例）和对照组（肝硬化，123例）。比较2组病人一般资料和血脂水平三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）]，并进行ROC曲线分析。根据观察组病人上消化道出血量分为轻症组和重症组，分析血脂水平与疾病严重程度的相关性。结果2组病人TG水平比较，差异无统计学意义（P>0.05），但观察组病人TC、LDL-C和HDL-C水平均低于对照组（P < 0.01）；联合诊断的曲线下面积、敏感度和特异度均大于单一指标诊断，其中当TC≤2.69 mmol/L，HDL-C≤0.98 mmol/L，LDL-C≤1.61 mmol/L，肝硬化病人发生上消化道出血的概率均会增加（P < 0.01）；2组病人TG水平比较，差异无统计学意义（P>0.05），但轻症组病人TC、LDL-C和HDL-C水平均高于重症组（P < 0.05~P < 0.01）；Spearman相关性分析显示TG与疾病严重程度无相关性（P>0.05），TC、LDL-C和HDL-C均与疾病严重程度呈负相关关系（P < 0.05）。结论肝硬化合并上消化道出血病人血脂水平显著降低，且均与出血严重程度呈负相关，可作为肝硬化病人上消化道出血发生的预测因子。

Study on the correlation between liver cirrhosis complicated with upper gastrointestinal bleeding and blood lipid levels

ObjectiveTo study the correlation between liver cirrhosis combined with upper gastrointestinal bleeding and blood lipid levels.MethodsThe general data of 205 patients with liver cirrhosis were retrospectively analyzed, and the patients were divided into the observation group(liver cirrhosis combined with upper gastrointestinal bleeding, 82 cases) and control group(liver cirrhosis, 123 cases) according to with or without complicated with upper gastrointestinal bleeding.The general data and blood lipid levelstriglyceride(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C)] were compared between two groups, and the ROC curve analysis was performed.The observation group was subdivided into the mild group and severe group according to the amount of upper gastrointestinal bleeding, and the correlation between blood lipid levels and disease severity was analyzed.ResultsThere was no statistical significance in TG level between two groups(P>0.05), but the levels of TC, LDL-C and HDL-C in observation group were significantly lower than those in control group(P < 0.01).The area under the curve, sensitivity and specificity of the combined diagnosis were greater than those of the single index diagnosis.When TC ≤ 2.69 mmol/L, HDL-C ≤ 0.98 mmol/L, LDL-C ≤ 1.61 mmol/L, the probability of upper gastrointestinal bleeding in patients with liver cirrhosis would increase(P < 0.01).There was no statistical significance in TG level between two groups(P>0.05), but the levels of TC, LDL-C and HDL-C in mild group were significantly higher than those in severe group(P < 0.05 to P < 0.01).The results of Spearman correlation analysis showed that the TG level was not correlated with disease severity(P>0.05), while the levels of TC, LDL-C and HDL-C were negatively correlated with the disease severity(P < 0.05).ConclusionsThe blood lipid levels in patients with liver cirrhosis complicated with upper gastrointestinal bleeding significantly decrease, and all are negatively correlated with the severity of bleeding, which can be used as a predictive factor of upper gastrointestinal bleeding in patients with liver cirrhosis.