The Research Of Serum 25OHD3 And Clinical Significance In Liver Cirrhosis With Different Degree Of Esophageal Varices

Objectives: To explore the level of serum 25-hydroxyvitamin D3?25OHD₃?and clinical significance on patients between who suffered from liver cirrhosis with different degree of esophageal varices?EV?and those who with cirrhosis complicated with esophageal variceal bleeding?EVB?.Method: The patients in liver cirrhosis with EV were chosen as the experimental subjects,They all from Digestive department of Shan Xi Provincial People's hospital?treatment timing: 11.2016¹.2017?,and can be divided into two groups: a total of 51 patients is bleeding group?group1?,which including male 28 and female 23;age:36⁸1,they are moderate or severe EV patients;while group2 is non-bleeding group,total number: 32,including male 15 and female 17;age 26⁸6.According to the different degree of EV,the group2 also can be separated into moderate and severe patients?the total of number: 18?;mild and non-EV patient?the total of number:14?.The data of the two groups were analyzed by univariate analysis,the correlation variables and the correlation intensity analysis of liver cirrhosis with esophageal variceal bleeding,and the correlation analysis between Spearman variables will also be adopted.Besides,observe the changes of 25OHD₃ levels in patients with different degrees of EV,and the risk of bleeding was predicted by the implication of area under the curve?AUC?.Results:In the application of univariate analysis,normality test,comparison between ALB and AAR adopted by T test,and meanwhile the other variables were compared by the method of Mann-Whitney test,we found that Hb?P=0.005?,ALT?P=0.001?,AST?P=0.013?,AKP?P=0.002?,GGT?P=0.022?,LN?P=0.009?,25OHD₃?P=0.002?,there were significantly lower than the non-bleeding group.While there were no significant difference between the two groups?P>0.05?like WBC,PLT,AST,ALB,TB,PT-S,IL6,HA,NP,IV-Col,AAR?APRI?FIB-4 and King.Logistic regression analysis was applied to identity variables correlation with EVB in cirrhotic patients,and it turned out that 25OHD₃,ALT,AKP,Hb were the independent risk factors for EVB.By using Spearman correlation test,we can found that there has positive correlation between 25OHD₃ and IL-6?r=0.306,P=0.005?,on the other hand,there has negative correlation between 25OHD₃ and IL-6?r=-0.327,P=0.003?.In the group2,the level of 25OHD₃ in mild EV was significantly lower than that in the moderate or severe EV?P=0.04?.there was no significant difference between the mild EV in group2 and the moderate,severe EV in group1?P=0.281?.By the implication of AUROC,make a prediction of the danger of bleeding,AUC was 0.705,P=0.002,?95% confidence interval[CI]=0.591-0.820?.Youden index was 0.366,critical value of 25OHD₃ was 10.94ng/ml,the sensitivity was 71.9%,specificity was 64.7%.Conclusion: 1.The degree of 25OHD₃ in liver cirrhosis with EVB was significantly reduced.2.The high level of 25OHD₃ may prevent EVB.3.the Low level of 25OHD₃ do not have the ability to distinguish the degree of EV,once the moderate and severe patients with low levels of 25OHD₃,EVB will be occurred.It can be used as a non-invasive method to predict the occurrence of EVB in moderate and severe EV.