The Correlated Risk Factors For The First Rupture Bleeding Of Esophageal Varices In Patients With Cirrhosis

Objective: Through comprehensive systematic regression analysis of the general information, signs, laboratory examinations, type-B ultrasonic and gastroscope in patients with HC with EVB investigating the risk factors of this disease.Methods: Choose 176 patients firit variceal bleeding of cirrhosis hospitalized in the Affiliated Hospital of Nanchang University during april 2014 to march 2015 as variceal hemorrhage group. Meanwhile, 100 cirrhosis without variceal bleeding patients were selected as none variceal hemorrhage group, compare two group with retrospective analysis. 31 indexes including general information( gender, age, etiology, causes of disease, incidence of month, basic heart rate), General signs(liver-palms, spider, ascetic fluid), biochemical criterion(PLT, PT, PTA, APTT, TBIL, ALB, TP, Na+, K+, HBV-DNA), type-B ultrasonic(PV, SV, ST), gastroscope(PHG, PU, RC sign, GV, the thickest esophageal varicose vein diameter, began to distance from incisors varicose parts, the degree of EV) and other information like Child-Pugh classification and location of EVB were collected, univariate analysis to analyse 28 /30 indexes, the indexes with statistical significant difference(p<0.05) undertook non-conditional logistic regression analysis to confirm the main risk factors of EVB with cirrhosis. Statistic the number of EVB each month in a year to identify the difference, in order to illustrate the relationship between the cause of disease and bleeding site.Results: EVB occur mostly in the first two months of a year, and then are October to December, which account for 65.9% of total number of EVB. Univariate analysis confirm that 14 indexes including spider, PLT, PT, PTA, TBIL, ALB, TP, PV, SV, the thickest esophageal varicose vein diameter, began to distance from incisors varicose parts, the degree of EV, RC sign, Child-Pugh classification have statistical significant difference(P <0.05). Non-conditional logistic regression analysis showed that RC sign, SV, PV, the thickest esophageal varicose vein diameter, the degree of EV, PT are positive correlate with EVB morbidity, while PLT is negative correlate with EVB morbidity, the relative coefficient are 2.922, 2.348, 2.335, 1.916, 1.145, 0.253 and-0.014 respectively. Odds ratio(OR) were 18.581, 10.462, 10.334, 6.794, 3.143, 1.288, 0.987 respectively. EVB of HC mostly occur at the middle and lower segment of esophagus and cardia.Conclusion: EVB occur mostly in autumn and winter in Jiangxi province. Independent risk factors of EVB including RC sign, SV, PV, the thickest esophageal varicose vein diameter,the degree of EV, PT, PLT, the main risk factor is RC sign. Bleeding site of EVB concentrated on middle and lower segment of esophagus(33-40cm), cardia, stomach fundus.