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肝硬化合并脑梗死和/或上消化道出血患者的预后分析:一项回顾性队列研究。

Prognostic Analysis of Liver Cirrhosis Patients with Cerebral Infarction and/or Gastrointestinal Hemorrhage: A Retrospective Cohort Study.

机构信息

Center of Digestive Endoscopy, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210017, China.

Huaiyin Hospital of Huai'an City, Huaian 223300, China.

出版信息

Comput Math Methods Med. 2022 Aug 4;2022:2566746. doi: 10.1155/2022/2566746. eCollection 2022.

Abstract

BACKGROUND

To explore the risk factors of gastrointestinal hemorrhage and/or cerebral infarction complications in liver cirrhosis and provide evidence for early prevention, clinical diagnosis, and treatment of liver cirrhosis.

METHODS

200 liver cirrhosis patients were analyzed: liver cirrhosis ( = 78), liver cirrhosis complicated with cerebral infarction ( = 43), liver cirrhosis complicated with gastrointestinal hemorrhage ( = 57), and liver cirrhosis complicated with gastrointestinal hemorrhage and cerebral infarction ( = 22). The incidence of disease in each group of patients at different times was calculated. Multivariate logistic regression was used to analyze the risk factors of liver cirrhosis patients with gastrointestinal hemorrhage and cerebral infarction. After 12 months of follow-up, the mortality rate of each group was calculated.

RESULTS

The incidences of gastrointestinal hemorrhage, cerebral infarction, and gastrointestinal hemorrhage combined with cerebral infarction in patients with liver cirrhosis were 21.5%, 28.5%, and 11%, respectively. The width of the portal vein, D-2 polymer, albumin (ALB), and hemoglobin (Hb) were predictors of gastrointestinal hemorrhage and cerebral infarction in patients with liver cirrhosis. Age, hypertension, bleeding history, infection, portal vein width, and D-2 polymer were confirmed as risk factors for gastrointestinal hemorrhage and cerebral infarction in patients with liver cirrhosis. ALB and Hb were independent protective factors. Patients with liver cirrhosis and gastrointestinal hemorrhage with cerebral infarction had the worst survival.

CONCLUSION

Age, hypertension, bleeding history, infection, portal vein width, and D-2 polymer are all independent risk factors for gastrointestinal bleeding and cerebral infarction, while ALB and Hb are independent protective factors.

摘要

背景

探讨肝硬化患者并发胃肠道出血和/或脑梗死并发症的危险因素,为肝硬化的早期预防、临床诊断和治疗提供依据。

方法

分析 200 例肝硬化患者:肝硬化(n=78)、肝硬化合并脑梗死(n=43)、肝硬化合并胃肠道出血(n=57)、肝硬化合并胃肠道出血和脑梗死(n=22)。计算各组患者不同时间的疾病发生率。采用多因素 logistic 回归分析肝硬化患者并发胃肠道出血和脑梗死的危险因素。随访 12 个月后,计算各组的死亡率。

结果

肝硬化患者胃肠道出血、脑梗死和胃肠道出血合并脑梗死的发生率分别为 21.5%、28.5%和 11%。门静脉宽度、D-2 聚合物、白蛋白(ALB)和血红蛋白(Hb)是预测肝硬化患者胃肠道出血和脑梗死的指标。年龄、高血压、出血史、感染、门静脉宽度和 D-2 聚合物被确认为肝硬化患者并发胃肠道出血和脑梗死的危险因素。ALB 和 Hb 是独立的保护因素。同时患有肝硬化和胃肠道出血合并脑梗死的患者生存情况最差。

结论

年龄、高血压、出血史、感染、门静脉宽度和 D-2 聚合物均是胃肠道出血和脑梗死的独立危险因素,而 ALB 和 Hb 是独立的保护因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5807/9371864/951db3ba30c1/CMMM2022-2566746.001.jpg

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