肝硬化食管静脉曲张首次破裂出血相关危险因素分析

目的:探讨肝硬化食管静脉曲张首次破裂出血的相关危险因素及其与出血联系的紧密程度,以尽早识别出高危患者。方法:回顾性分析肝硬化食管静脉曲张首次破裂出血的患者105例(观察组)及同期住院的肝硬化食管静脉曲张未破裂出血患者105例(对照组)的临床资料,先行单因素分析,再对两组间有统计学差异的指标进行多因素非条件Logistic回归分析,最后与出血联系最紧密的两个因素行双因素非条件Logistic回归分析。结果:单因素分析显示两组资料中凝血酶原时间(P0.01)、门静脉内径(P0.05)、肝功能Child分级(P0.01)、红色征(P0.01)、食管静脉曲张程度(P0.01)的差异有统计学意义,多因素非条件Logistic回归分析提示红色征(OR=2.728,P=0.016)、食管静脉曲张程度(OR=2.126,p=0.008)为出血的独立危险因素,双因素非条件Logistic回归分析提示同时存在重度食管静脉曲张和红色征与单纯重度食管静脉曲张相比较,差异有统计学意义(OR=1.812,P=0.008)。结论:红色征、食管静脉曲张程度为肝硬化食管静脉曲张首次破裂出血的独立危险因素,对预测食管静脉曲张首次破裂出血有重要的临床意义。

The Correlated Risk Factors for the First Rupture Bleeding of Esophageal Varices in Patients with Cirrhosis

Objective：To investigate the correlated risk factors for the first time rupture bleeding of esophageal varices （EVB） in patients with cirrhosis and the compact degree of the factors to accurately identify patients at high risk. Methods：A retrospective study was performed to compare some clinical datas of 105 first time EVB cases with 105 non-bleeding esophageal varices （EV） cases. Clinical parameters between the two groups were compared by univariate analysis and multivariate Logistic regression analysis in order to analyze the compact degree with bleeding. Picked up the firmest two indexes to apply double factor Logistic regression analysis. Results： Between the two groups prothrombin time, diameter of the portal vein, Child-Pugh classification, red color sign and degree of EV had statistical difference （P〈0.05 or P〈0.01 ）.Multivariate Logistic regression analysis showed that red color sign （OR=2.728 ,P= 0.016）and degree of EV （OR = 2.126,P = 0.008）were independent risk factors for EVB.Combined severe degree of EV and red color sign with single severe degree of EV resulted significantly statistical difference in double factors Logistic regression analysis. Conclusions ： Red color sign and degree of EV are the independent risk factors for EVB in patients with cirrhosis, which may be important clinical predictors.