摘要
[目的]探讨肝硬化上消化道出血患者并发肝性脑病的危险因素,为临床早期干预提供依据。[方法]选取肝硬化并发上消化道出血患者235例,依据是否并发肝性脑病,分为病例组(并发肝性脑病组)93例,对照组(没有并发肝性脑病组)142例。对2组患者的临床资料采用单因素和多因素非条件Logistic回归进行统计学分析,筛选出肝硬化上消化道出血患者并发肝性脑病的危险因素。[结果]单因素分析结果显示:病例组和对照组在WBC、PLT、ALT、ALB、TBIL、BUN、Scr、Na+、AM、PT、肝功能CTP评分、腹水、感染方面比较,P<0.05,差异有统计学意义;多因素非条件Logistic回归分析结果显示:血氨增加(OR=1.237,P=0.042)、肝功能CTP评分增加(OR=1.328,P=0.027)、血肌酐增加(OR=2.427,P=0.039)、腹水增多(OR=1.546,P=0.034)是硬化上消化道出血患者并发肝性脑病的危险因素。[结论]更高的血氨、更高的肝功能CTP评分、更高的血肌酐、更多的腹水是硬化上消化道出血患者并发肝性脑病的独立危险因素。
[Objective] To explore the risk factors of hepatic encephalopathy in patients with upper gastrointestinal hemorrhage due to cirrhosis and to provide evidence for early clinical intervention.[Methods]235 patients with liver cirrhosis complicated with upper gastrointestinal bleeding were divided into case group(hepatic encephalopathy group)93 cases and control group(no hepatic encephalopathy group)142 cases.[Results]Univariate analysis showed that there were significant differences in WBC,PLT,ALT,ALB,TBIL,BUN,Scr,Na+,AM,PT,liver function CTP score,ascites and infection between the two groups(P<0.05).Multivariate unconditional logistic regression analysis showed that increased serum ammonia(OR=1.237,P=0.042),increased liver function CTP score(OR=1.328,P=0.027),increased serum creatinine(OR=2.427,P=0.039),and increased ascites(OR=1.546,P=0.034)were risk factors for hepatic encephalopathy in patients with upper gastrointestinal hemorrhage due to cirrhosis.[Conclusion]Higher serum ammonia,higher liver function CTP score,higher serum creatinine and more ascites are independentrisk factors for hepatic encephalopathy in patients with upper gastrointestinal hemorrhage due to cirrhosis.
作者
张飞
刘斌
施彦卿
吴时胜
ZHANG Fei;LIU Bin;SHI Yan-qing;WU Shi-sheng(Department of Gastroenterology,The Second People's Hospital of Huangshi,Hubei,Huangshi 435000,China;Department of Gastroenterology,North China University of Science and Technology,Hebei ,Tangs-han 063000,China;Department of Gastroenterology,Affilated Hospital of Jiujiang University,Jiangxi ,Jiu-jiang 332000,China)
出处
《中国中西医结合消化杂志》
CAS
2018年第11期934-937,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
中国肝炎防治基金会资助项目(No:TQGB20170015)
关键词
肝硬化
上消化道出血
肝性脑病
危险因素
liver cirrhosis
upper gastrointestinal bleeding
hepatic encephalopathy
risk factors