肝硬化并反流性食管炎的相关因素研究

Prevalence and Risk Factors of Reflux Esophagitis among Patients with Liver Cirrhosis

摘要: 目的：探讨肝硬化患者中反流性食管炎(reflux esophagitis, RE)的发生率及危险因素。方法：连续选取住院部2018年1月至2023年6月期间164例肝硬化并RE患者，作为病例组；随机抽取同时期176例无RE的肝硬化患者作为对照组。对两组患者的一般资料、胃镜下表现、并发症进行单因素分析，多因素分析确定危险因素。结果：我院肝硬化患者中RE的发生率为3.97%。两组患者在性别、饮酒史、内镜治疗史、血红蛋白、白细胞、甘油三酯、天冬氨酸氨基转移酶、腹水、食管胃底静脉曲张、胆汁反流、食管裂孔疝的差异有统计学意义(P均 < 0.05)。Logistic回归分析提示既往接受过内镜下硬化剂注射治疗、食管裂孔疝、中大量腹水、胆汁反流、白细胞升高、甘油三酯升高是肝硬化患者中发生RE的危险因素，而既往接受过内镜下曲张静脉套扎治疗是RE的保护因素(P均 < 0.05)。结论：肝硬化住院患者中RE的发生率为3.97%，既往接受过内镜下硬化剂注射治疗或病程中出现严重腹水的肝硬化患者发生RE的风险增加。

Abstract: Objective: To investigate the prevalence and risk factors of reflux esophagitis (RE) in patients with liver cirrhosis. Methods: 164 patients with liver cirrhosis and RE hospitalized from January 2018 to June 2023 were consecutively selected as case group, and 176 cirrhotic patients without RE in the same period were randomly selected as control group. The general data, gastrointestinal comorbidities, and complications of the two groups were analyzed in a univariate manner, and the risk factors were determined by a multifactorial analysis. Results: The prevalence of RE among cirrhotic patients was 3.97%. Male, alcohol intake, previous endoscopic treatment, haemoglobin, white blood cells, triglycerides, aspartate aminotransferase, ascites, esophagogastric varices, bile reflux and hiatal hernia were statistically significant between the two groups (P < 0.05). Logistic regression analysis suggested that previous endoscopic injection sclerotherapy, hiatal hernia, moderate to large amounts of ascites and bile reflux, leukocytes and triglycerides were risk factors for the development of RE in patients with liver cirrhosis, whereas previous endoscopic variceal ligation was a protective factor for RE (P < 0.05). Conclusion: The prevalence of RE among inpatients with liver cirrhosis was 3.97%. Patients with a history of endoscopic injection sclerotherapy or severe ascites were more likely to develop RE.