王勇　孙琳

【摘要】 目的：分析血清25羥维生素D3（25-hydroxyvitamin D3，25OHD3）水平与肝硬化食管静脉曲张破裂出血（esophageal varices bleeding，EVB）的关系，为临床预测EVB提供依据。方法：回顾性分析2019年5-11月于笔者所在医院接受诊治的肝硬化患者的临床资料，筛选其中80例作为研究对象，依据是否发生EVB分为出血组（n=48）与未出血组（n=32），另选同期进行健康体检者20例作为对照组。对比三组血清25OHD3、血红蛋白（hemoglobin，Hb）、白蛋白（albumin，ALB）水平，分析25OHD3与Hb、ALB水平的相关性，根据一般线性回归分析结果评价血清25OHD3、Hb、ALB水平与肝硬化EVB的关系。结果：对照组血清25OHD3、Hb、ALB水平均高于未出血组及出血组，未出血组血清25OHD3、Hb、ALB水平均高于出血组，差异均有统计学意义（P<0.05）;血清25OHD3水平与Hb、ALB水平均呈正相关，差异均有统计学意义（P<0.05）;血清25OHD3、Hb、ALB水平较低均是导致肝硬化EVB发生的危险因素，差异均有统计学意义（P<0.05）。结论：血清25OHD3、Hb、ALB水平与肝硬化EVB具有密切关系，三项指标水平愈低，患者发生EVB的风险愈大。

【关键词】 肝硬化 食管静脉曲张破裂出血 25羟维生素D3

doi：10.14033/j.cnki.cfmr.2020.21.049 文献标识码 B 文章编号 1674-6805（2020）21-0-03

Relationship between Serum 25OHD3 and Esophageal Variceal Bleeding in Cirrhosis/WANG Yong， SUN Lin. //Chinese and Foreign Medical Research， 2020， 18（21）： -120

[Abstract] Objective： To analyze the relationship between serum 25-hydroxyvitamin D3 （25OHD3） levels and esophageal varices bleeding （EVB） in cirrhosis， and to provide a basis for clinical prediction of EVB. Method： The clinical data of patients with cirrhosis treated in our hospital from May to November 2019 were retrospectively analyzed， and 80 of them were selected as study subjects， according to whether EVB occurred or not， they were divided into the bleeding group （n=48） and the no bleeding group （n=32）， and another 20 patients with health examination in our hospital were selected as the control group in the same period. Serum 25OHD3， hemoglobin （Hb） and albumin （ALB） levels were compared in three groups to analyze the correlation of 25OHD3 and Hb and ALB levels. The relationship between serum 25OHD3， Hb and ALB levels and EVB in cirrhosis was evaluated according to the results of general linear regression analysis. Result： The levels of serum 25OHD3， Hb and ALB of the control group were higher than those of the no bleeding group and the bleeding group， and the levels of serum 25OHD3， Hb and ALB of the no bleeding group were higher than those of the bleeding group， and the differences were statistically significant （P<0.05）. Serum 25OHD3 level was positively correlated with the levels of Hb and ALB， and the differences were statistically significant （P<0.05）. Low levels of serum 25OHD3， Hb and ALB were risk factors for EVB in cirrhosis， and the differences were statistically significant （P<0.05）. Conclusion： The levels of serum 25OHD3， Hb， ALB are closely related to EVB in cirrhosis， the lower the level of the three indicators， the greater the risk of EVB.

[Key words] Cirrhosis Esophageal variceal bleeding 25-hydroxyvitamin D3

First-authors address： Qichun County Peoples Hospital， Qichun 435300， China

肝硬化为慢性进行性肝病，是一种弥漫性肝损伤。肝硬化患者多伴有食管静脉曲张，而食管静脉曲张则是上消化道出血的常见病因[1]。食管静脉曲张破裂出血（EVB）会严重影响肝硬化患者的预后，故探索肝硬化EVB的预测因素具有重要意义。研究显示，肝硬化患者多伴有血清25羟维生素D3（25OHD3）水平降低情况[2]。基于此，本研究分析血清25OHD3水平与肝硬化EVB的关系，旨在为临床预测EVB的发生提供依据，报道如下。

1 资料与方法

1.1 一般资料

回顾性分析2019年5-11月于笔者所在医院接受诊治的肝硬化患者80例的临床资料;另选取同期于笔者所在医院进行健康体检者20例。纳入标准：（1）根据肝穿刺活检确诊为肝硬化;（2）临床资料与影像学资料完整。排除标准：（1）合并门静脉高压性胃病、急性出血性胃炎、异位静脉曲张等病症;（2）发生明显的血流动力学改变;（3）合并慢性肾功能衰竭、糖尿病、风湿性疾病等会影响维生素D代谢的疾病;（4）近期使用过骨化三醇等药物。……