Risk Factors Of Upper Gastrointestinal Bleeding And Rebleeding In Patients With Liver Cirrhosis Complicated With Portal Vein Thrombosis

Objective:The purpose of this study is to investigate the risk factors of upper gastrointestinal bleeding and rebleeding in patients with liver cirrhosis and portal vein thrombosis,and to provide reference for clinical treatment.Methods:A total of 109 patients diagnosed with liver cirrhosis and portal vein thrombosis at The First Affiliated Hospital of Gannan Medical College from January 2019 to December 2022 were retrospectively collected.According to the presence or absence of upper gastrointestinal bleeding and the number of bleeding episodes,the patients were divided into PVT group(liver cirrhosis with portal vein thrombosis without bleeding),PVT-B group(liver cirrhosis with portal vein thrombosis with the first occurrence of upper gastrointestinal bleeding),and PVT-RB group(liver cirrhosis with portal vein thrombosis with recurrent upper gastrointestinal bleeding).SPSS 21.0software was used to analyze the general clinical characteristics and laboratory related indicators of patients.Binary Logistic regression was used to screen out the independent risk factors of upper gastrointestinal bleeding and re-bleeding in liver cirrhosis with portal vein thrombosis,and the characteristic operating curve(ROC)was drawn to evaluate the predictive ability.Results:1.General clinical characteristics between PVT group and PVT-B group: Gender,past history(hypertension,diabetes,coronary heart disease),smoking history,family history of liver cirrhosis,history of surgical intervention,white blood cell,platelet,C-reactive protein,glutamic acid aminotransferase,aspartate aminotransferase,triglyceride,creatinine were not statistically significant(P > 0.05).The causes of liver cirrhosis(hepatitis B cirrhosis,alcoholic cirrhosis),history of non-selective β-blocker use,hemoglobin,and Child-Pugh classification were statistically significant(P < 0.05).The related risk factors(gender,etiology of liver cirrhosis,hemoglobin,Child-Pugh classification,history of β-blocker use)with p < 0.1 in univariate analysis of PVT group and PVT-B group were included in the total equation.Hemoglobin and Child-Pugh classification were screened as independent risk factors for the first occurrence of upper gastrointestinal bleeding in patients with liver cirrhosis and portal vein thrombosis.2.General clinical characteristics between PVT-B group and PVT-RB group: Gender,etiology of liver cirrhosis(hepatitis B cirrhosis,alcoholic cirrhosis),past history,history of hypertension,diabetes,coronary heart disease,smoking history,family history of liver cirrhosis,hemoglobin,white blood cell,platelet,C-reactive protein,glutamic acid aminotransferase,aspartate aminotransferase,triglyceride,creatinine,and Child-Pugh classification were not controlled Statistical significance(P > 0.05),the history of non-selective β-blocker use and surgical intervention were statistically significant(P < 0.05);In univariate analysis,the related risk factors(aspartate aminotransferase,history of non-selective β-receptor blocker use,and history of surgical intervention)with p < 0.1 in PVT-B group and PVT-RB group were included in the total equation,and the history of non-selective β-receptor blocker use and history of surgical intervention were screened out as independent risk factors for recurrent upper gastrointestinal bleeding in liver cirrhosis complicated with portal vein thrombosis.Conclusions:1.Etiology of liver cirrhosis,non-selective β-blockers,hemoglobin and Child-Pugh classification were the related factors for the first occurrence of upper gastrointestinal bleeding in liver cirrhosis complicated with portal vein thrombosis.2.Hemoglobin and Child-Pugh classification are independent risk factors for the first occurrence of upper gastrointestinal bleeding in patients with liver cirrhosis and portal vein thrombosis.Non-selective β-blockers and surgical intervention are independent risk factors for recurrent bleeding in patients with liver cirrhosis and portal vein thrombosis...