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目的探讨晚期血吸虫病患者食管胃底静脉破裂出血的相关危险因素,为其早期防治提供依据。方法以45例患晚期血吸虫病且食管胃底静脉破裂出血者为病例组,60例患该病但未发生出血者为对照,均选自2007年9月-2009年9月湖南省血吸虫病防治所附属湘岳医院住院患者。采用单因素分析及多因素非条件Logistic回归分析其影响因素。结果单因素分析表明腹水、血小板、APTT、血氨、血钠、肝功能分级、总蛋白、脾脏厚度、食管静脉曲张度、胃底静脉曲张与并发出血有关(P<0.05);选取相关因素进行多因素非条件Logistic回归分析,结果显示腹水、血小板、总蛋白、肝功能分级、食道静脉曲张度和脾脏厚度的偏回归系数差异有统计学意义(P<0.05),其中脾脏厚度的偏回归系数为负(B=-0.15),OR值以总蛋白最大(OR=14.50)。结论血小板、腹水、总蛋白、肝功能分级和食管静脉曲张度为晚期血吸虫病并发食管胃底静脉破裂出血的危险因素,且以总蛋白的影响最大;脾脏厚度为保护因素。
Objective To investigate the risk factors of esophageal-gastric-venous rupture in patients with advanced schistosomiasis and provide basis for its early prevention and treatment. Methods 45 cases of advanced schistosomiasis and esophageal and gastric variceal bleeding were selected as the case group, 60 cases of the disease but no bleeding as a control, were selected from September 2007 - September 2009 prevention and treatment of schistosomiasis in Hunan Province Affiliated Xiang Yue Hospital inpatients. Univariate analysis and multivariate non-conditional Logistic regression analysis of its influencing factors. Results Univariate analysis showed that ascites, platelet, APTT, serum ammonia, serum sodium, liver function grading, total protein, spleen thickness, esophageal varices, gastric varices were associated with concurrent bleeding (P <0.05) Multivariate non-conditional Logistic regression analysis showed that the partial regression coefficients of ascites, platelet, total protein, liver function grading, esophageal varices and spleen thickness had statistical significance (P <0.05), and the partial regression coefficient of spleen thickness Is negative (B = -0.15), OR value is the largest total protein (OR = 14.50). Conclusions Platelet, ascites, total protein, grade of liver function and esophageal varicosity are the risk factors of advanced schistosomiasis with esophageal-gastric-venous rupture and have the greatest influence on total protein. Spleen thickness is the protective factor.