通讯作者: 杨正武, yzwsdta@163.com

DOI：10.12201/bmr.202504.00075

Analysis of risk factors associated with the first complication of gastrointestinal bleeding in hepatitis B cirrhosis

• 摘要：目的：探究乙型肝炎肝硬化患者首次消化道出血的危险因素并构建预测模型。方法：收集山东第一医科大学第二附属医院2022年1月至2024年12月明确诊断为乙型肝炎肝硬化的患者,筛选因首次消化道出血住院的患者作为出血组,未发生消化道出血的患者作为对照组。比较两组患者的一般资料,分析乙型肝炎肝硬化患者首次并发上消化道出血的可能危险因素。采用SPSS 27.0软件进行统计分析：二分类变量采用卡方检验；连续性变量经正态性检验,符合正态分布的采用t检验,等级变量采用非参数秩和检验。将有统计学意义的指标纳入Logistic回归分析,筛选消化道出血的独立危险因素,并构建乙肝肝硬化首次并发消化道出血的ROC曲线。结果：单因素分析提示,肝功能分级C级、低水平RBC、PLT、FIB、ALB、PTA及PT时间延长、INR高比值、门静脉主干内径及重度食管胃底静脉曲张为乙型肝炎肝硬化首次并发消化道出血的危险因素,差异有统计学意义(P＜0.05)；多因素分析显示,RBC、门静脉内径及重度食管胃底静脉曲张为乙型肝炎肝硬化并发消化道出血的独立危险因素。结论：当RBC＜3.25×10?/L、门静脉内径＞14.5 mm及存在重度食管静脉曲张时,联合诊断对乙型肝炎肝硬化首次并发上消化道出血的风险预测价值较高,应及时采取干预措施。

  关键词： 乙型肝炎肝硬化; 消化道出血; 危险因素; 预测模型

   

  Abstract: Objective：To investigate the risk factors for first gastrointestinal bleeding in cirrhotic patients with hepatitis B and to construct a predictive model. Methods：Patients were collected with definite diagnosis of hepatitis B cirrhosis in the Second Affiliated Hospital of Shandong First Medical University from January 2022 to December 2024. Patients hospitalized for first gastrointestinal bleeding were also screened as the bleeding group and those who had not experienced gastrointestinal bleeding as the control group, and the general data of the patients in the bleeding and non-bleeding groups were compared,then analysis of possible risk factors affecting the first complication of upper gastrointestinal bleeding in patients with hepatitis B cirrhosis. The inclusion indicators were analyzed for differences and all statistical analyses were performed using SPSS 27.0 software. The chi-square test was used for dichotomous variables; continuous variables were tested for normality, and t-tests were used for those that conformed to normal distribution, and nonparametric rank-sum tests were used for hierarchical variables. Meaningful indicators were included in logistic regression analysis to screen independent risk factors for gastrointestinal bleeding, and ROC curves were constructed for the first complication of gastrointestinal bleeding in hepatitis B cirrhosis. Results：Univariate analysis suggested that liver function grade C, low level of RBC, PLT, FIB, ALB, PTA and prolonged PT time, high ratio of INR, internal diameter of portal vein trunk and severe esophageal varices were the risk factors for the first complication of gastrointestinal hemorrhage in cirrhosis of hepatitis B. The difference was statistically significant (p < 0.05); multifactorial analysis showed that RBC, portal vein internal diameter and severe esophagogastric fundal varices were hepatitis B cirrhosis complicated by upper gastrointestinal bleeding. Conclusion：When RBC <3.25*109/L, portal vein internal diameter >14.5 mm and the presence of severe esophageal varices joint diagnosis of hepatitis B cirrhosis with first complication of the upper gastrointestinal tract has a greater predictive value, and should be intervened in a timely manner.

  Key words: hepatitis B cirrhosis; gastrointestinal bleeding; risk factors; predictive modeling

  提交时间：2025-04-29

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
• html

• 图表

• 相伟英, 李杭剑, 童铭炯. 慢性乙型肝炎肝硬化失代偿期继发肾损伤的危险因素及预后分析. 2024. doi: 10.12201/bmr.202409.00056

  李金娥, 周彬. 聚乙二醇干扰素a治疗慢性乙型肝炎诱发尿路感染致急性尿道梗阻1例. 2024. doi: 10.12201/bmr.202408.00052

  周妮, 谷强. 儿童大叶性肺炎病程的危险因素及风险预测. 2025. doi: 10.12201/bmr.202504.00059

  施明杰, 叶洪舟, 袁琛. 大环内酯类耐药肺炎支原体肺炎患儿发展为重症肺炎的危险因素分析及预测模型构建. 2024. doi: 10.12201/bmr.202409.00021

  徐瑾, 阿克忠, 郝增平, 巴文生, 关炳菊, 李晓萍, 杜星星, 刘晓庆, 马贵艳. 青海省乙型病毒性肝炎住院病例诊断报告一致性及影响因素分析. 2025. doi: 10.12201/bmr.202501.00057

  王玥琳, 蒋运兰, 李乐, 陈红, 王镜, 张梦洁, 白小雨, 武森林. 中国精神分裂症住院患者并发代谢综合征危险因素的Meta分析. 2025. doi: 10.12201/bmr.202504.00071

  王涛. 门诊老年2型糖尿病患者低血糖的危险因素分析. 2024. doi: 10.12201/bmr.202412.00069

  郭丰荥, 张涛. 东亚人群肠道菌群与肝硬化之间的关联:孟德尔随机化. 2024. doi: 10.12201/bmr.202412.00049

  王一凡, 石超君, 马安宁. Ⅱ型糖尿病并发动脉粥样硬化风险预测模型比较. 2024. doi: 10.12201/bmr.202404.00007

  钟怡, 刘鉴仪, 刘艳, 高云春, 金玲. 急性一氧化碳中毒后早期心肌损伤的危险因素及预后分析. 2025. doi: 10.12201/bmr.202504.00060

• 序号	提交日期	编号	操作
  1	2025-03-05	bmr.202504.00075V1	下载

• 公开评论  匿名评论  仅发给作者 提交评论