Clinical characteristics,risk factors and adverse prognostic factors of esophagogastric vari variceal bleeding in patients with hepatitis B cirrhosis
ZHU Zhichao
CAO Cuiyun
Abstract：Objective To investigate the clinical characteristics,pathogenic risk factors and adverse prognostic factors of esophagogastric variceal bleeding(EGVB)in patients with hepatitis B cirrhosis(HBV-related cirrhosis).Methods A retrospective analysis was performed on 150 patients with HBV-related cirrhosis complicated with EGVB admitted to Beijing Luhe Hospital Affiliated to Capital Medical University from October 2017 to October 2023,who were enrolled as the bleeding group.Meanwhile,another 150 patients with HBV-related cirrhosis complicated with esophagogastric varices(EGV)without bleeding were enrolled as the non-bleeding group.The clinical characteristics between the two groups were compared,and logistic regression analysis was applied to identify the risk factors for EGVB in patients with HBV-related cirrhosis.All 150 patients in the bleeding group were followed up for 1 year.According to the follow-up outcomes,20 patients who died or were readmitted due to recurrent bleeding within 1 year were assigned to the poor prognostic group,and the remaining 130 patients were assigned to the good prognosis group.The clinical characteristics of the two prognosis groups were compared,and logistic regression analysis was used to explore the factors influencing poor prognosis of EGVB in patients with HBV-related cirrhosis.Results Compared with the non-bleeding group,the bleeding group showed significant differences in the course of cirrhosis,Child-Pugh classification,degree of esophageal varices,presence of red signs,complicated cirrhotic ascites,history of accidental trauma,portal vein internal diameter,and alanine aminotransferase(ALT)levels(P<0.05);Logistic regression analysis revealed that Child-Pugh grade C,severe esophageal varices,presence of red signs,complicated cirrhotic ascites,history of accidental trauma,and ALT≥40 U/L were the main risk factors for EGVB in patients with HBV-related cirrhosis(P<0.05);Between the poor prognosis group and the good prognosis group,there were statistically significant differences in Child-Pugh classification,complicated cirrhotic ascites,complicated hepatic encephalopathy,complicated hemorrhagic shock,time from onset to treatment,bleeding volume≥500 mL,serum albumin level,and prothrombin time(P<0.05).Child-Pugh grade C,complicated hepatic encephalopathy,complicated hemorrhagic shock,time from onset to treatment≥4 hours,bleeding volume≥500 mL,and serum albumin<30 g/L were identified as the major risk factors for poor prognosis of EGVB in patients with HBV-related cirrhosis(P<0.05).Conclusion For patients with HBV-related cirrhosis,early assessment of Child-Pugh classification,degree of esophageal varices,presence of the red signs,complicated cirrhotic ascites,history of accidental trauma,and ALT level can help identify the risk of EGVB.After the occurrence of EGVB,close monitoring should be strengthened for patients with high Child-Pugh classification,complicated hepatic encephalopathy,complicated hemorrhagic shock,prolonged time from onset to treatment,bleeding volume≥500 mL or low serum albumin level,so as to adjust the treatment regimen in a timely manner and improve the prognostic outcomes.
Keywords：hepatitis B cirrhosisesophagogastric variceal bleedingclinical characteristicspoor prognosisrisk factors
Publication Date：2026-02-28
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：7( 44-50 )