肝硬化食管静脉曲张破裂出血危险因素的多变量分析

目的研究影响肝硬化患者食管静脉曲张破裂出血的危险因素。方法检测肝硬化患者的门静脉、脾静脉血流动力学指标和食管静脉曲张的胃镜下表现,以及他们的凝血酶原时间和血清转氨酶水平。通过相关分析初步筛选出可能有意义的指标,然后采用Logistic回归模型分析影响肝硬化患者食管静脉曲张破裂出血的主要因素。结果相关分析显示门静脉直径、流速、瘀血指数和脾静脉流速、瘀血指数以及曲张静脉的直径、红色征、凝血酶原时间均与食管静脉曲张破裂出血显著相关,但经多元Logistic回归分析,我们发现只有曲张静脉的红色征、凝血酶原时间以及脾静脉血流速度与肝硬化患者食管静脉曲张破裂出血相关。结论曲张静脉的红色征、凝血酶原时间以及脾静脉血流速度是影响肝硬化患者食管静脉曲张破裂出血的主要因素。

Multivariate analysis for risk factors of esophageal variceal hemorrhage in patients with liver cirrhosis

Objective To investigate the risk factors of esophageal variceal hemorrhage in liver cirrhotic patients.Methods The hemodynamics of portal vein and splenic vein were detected by color Doppler ultrasound. Meanwhile the endoscopic appearances of their varices together with their clinical parameters such as Protime and serum aminotransferase were examined.Authors screened approximately significant parameters by correlation analysis at first;then identified the major factors which may influence variceal hemorrhage in liver cirrhotic patients by Logistic regression mode.Results There were significant correlations of portal vein diameters(PVD), flow velocity(PVV), congestion index(PVCI) and splenic vein flow velocity(SVV), congestion index(SVCI) and varicose vein diameters, red color sign(RCS), Protime with variceal hemorrhage. But Logistic regression with multivariate analysis revealed that only RCS, Protime and SVV were correlated with variceal hemorrhage significantly.Conclusion RCS,Protime and SVV were major factors which may influence variceal hemorrhage in liver cirrhotic patients.