肝硬化并发门静脉高压性胃病危险因素的相关分析——附194例分析

Risk factors for portal hypertensive gastropathy in patients with liver cirrhosis.

目的:探讨肝硬化患者并发门静脉高压性胃病(portal hypertensive gastropathy,PHG)的危险因素。方法:对194例肝硬化患者的临床资料进行回顾性分析,用非条件Logistic回归模型从性别、年龄、病因、病程、肝功能分级、有无腹水、食管静脉曲张程度、门静脉内径、血浆白蛋白、总胆红素等10个变量中筛选出与门静脉高压性胃病发生最密切的危险因素。结果:194例肝硬化患者中80例合并PHG(PHG组),PHG发生率为41.2％;其中轻型68例,重型12例,8例引起上消化道出血;未并发PHG者114例(非PHG组)。单因素分析显示:PHG组的食管静脉曲张程度比非PHG组严重(P=0.000),PHG组的腹水发生率(74％)高于非PHG组(54％),P=0.007;PHG组的门静脉内径[(1.31±0.22)cm]比非PHG组[(1.23±0.19)cm]大,P=0.010;非条件Logistic回归分析显示食管静脉曲张程度是肝硬化并发门静脉高压性胃病的危险因素[比数比(odds ratio,OR)=3.025,P=0.000]。结论:食管静脉曲张程度越严重的肝硬化患者越容易发生PHG。

Objective: To explore the risk factors for portal hypertensive gastropathy(PHG) in patients with liver cirrhosis. Methods: One hundred and ninety-four patients with liver cirrhosis were studied retrospectively, and their sex, age, etiological factors, course, Child-Pugh class of liver function, ascites, the degree of esophageal varices, portal vessel diameters, the levels of plasma albumin and total bilirubin were analyzed by unconditional logistic regression to determine the risk factors for portal hypertensive gastropathy. Results: In 194 patients, 80 cases occurred PHG( PHG group). The prevalence rate was 41.2%. Mild gastropathy was found in 68 patients and severe gastropathy was found in 12 patients. Gastrointestinal bleeding occurred in 8 of 80 patients. 114 patients didn't occur PHG (non-PHG group). Univariate analysis showed that the degree of esophageal varices was more severe in PHG group (P=0.000). The prevalence of ascites was higher in PHG group(74%) than that in non-PHG group (54%) (P=0.007). Portal vessel diameter was larger in group PHG [(1.31±0.22)cm] than that in non-PHG group[(1.23±0.19)cm], P=0.010. Unconditional logistic regression analysis showed that the degree of esophageal varices was the risk factor for the portal hypertensive gastropathy in patients with liver cirrhosis[odds ratio(OR)=3.025, P=0.000]. Conclusion: The patients with severe esophageal varices are more likely to have portal hypertensive gastropathy.