Soga Koichi, Tomikashi Koichi, Miyawaki Ki-ichirou, Fukumoto Kohei, Wakabayashi Naoki, Konishi Hideyuki, Mitsufuji Shoji, Yoshida Norimasa, Kokura Satoshi, Naito Yuji, Kataoka Keisho, Yoshikawa Toshikazu
Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, Japan.
Hepatogastroenterology. 2009 Sep-Oct;56(94-95):1552-6.
BACKGROUND/AIMS: Ruptured esophagogastric varices are commonly associated with bleeding in patients with portal hypertension. However, the prediction of esophageal variceal bleeding is not matched by means of predicting gastric variceal bleeding. The present study aim is to elucidate risk factors for gastric variceal bleeding.
Twelve patients with gastric variceal bleeding and 18 patients receiving preventive treatment for gastric varices were included in the study.
The Child-Pugh (8.0 +/- 0.9 vs. 5.5 +/- 0.3; p = 0.0025) and Model for end-stage liver disease (MELD) (10.6 +/- 2.7 vs. 4.0 +/- 0.9; p = 0.0095) scores were significantly higher for patients with bleeding than for those receiving preventive treatment. Serum albumin concentration was significantly lower in bleeding than in preventive treatment cases, as determined by univariate (2.9 +/- 0.2 vs. 3.7 +/- 0.1 mg/dL; p < 0.0001) and multivariate analyses of serological data (odds ratio, 0.02, 95% confidence interval, 0.001-0.479; p = 0.0144).
The Child-Pugh and MELD scores were significantly higher for patients with gastric variceal bleeding than for those receiving preventive treatment, and multivariate analysis revealed that serum albumin was significantly lower in patients with gastric variceal bleeding. Control of serum albumin is important in preventing gastric variceal bleeding.
背景/目的：食管胃静脉曲张破裂通常与门静脉高压患者的出血相关。然而，食管静脉曲张出血的预测与胃静脉曲张出血的预测方法并不匹配。本研究旨在阐明胃静脉曲张出血的危险因素。
本研究纳入了12例胃静脉曲张出血患者和18例接受胃静脉曲张预防性治疗的患者。
出血患者的Child-Pugh评分（8.0±0.9对5.5±0.3；p = 0.0025）和终末期肝病模型（MELD）评分（10.6±2.7对4.0±0.9；p = 0.0095）显著高于接受预防性治疗的患者。单因素分析（2.9±0.2对3.7±0.1mg/dL；p < 0.0001）和血清学数据多因素分析（比值比，0.02，95%置信区间，0.001 - 0.479；p = 0.0144）显示，出血患者的血清白蛋白浓度显著低于预防性治疗患者。
胃静脉曲张出血患者的Child-Pugh评分和MELD评分显著高于接受预防性治疗的患者，多因素分析显示胃静脉曲张出血患者的血清白蛋白显著降低。控制血清白蛋白对预防胃静脉曲张出血很重要。
