C反应蛋白与白蛋白比值对肝硬化食管胃底静脉曲张出血患者术后再出血的影响
Effect of C-Reactive Protein/Albumin Ratio on Postoperative Rebleeding in Cirrhotic Patients with Esophagogastric Variceal Hemorrhage

目的：分析C反应蛋白/白蛋白比值对肝硬化食管胃底静脉曲张出血患者术后再出血的影响因素。方法：回顾性收集2018年5月至2022年12月在青岛大学附属医院就诊，行精准食管胃底静脉曲张断流术治疗的70例肝硬化食管胃底静脉曲张破裂出血患者，根据术前三天内的C反应蛋白/白蛋白比值，将患者分为高CAR组和低CAR组，比较二组患者术后1年内的再出血率，并分析患者术后1年内再出血的危险因素。结果：高CAR组患者1年内再出血率为36.8% (7/19)，低CAR组患者1年内再出血率为60.8% (31/51)，两组差异无统计学意义(Log-rank P = 0.120)，多因素结果显示门静脉血栓(HR = 2.19, 95%CI: 1.15~4.20, P = 0.018)是患者术后1年内再出血的独立危险因素。结论：CAR对肝硬化食管胃底静脉曲张出血患者术后1年内再出血无明显临床意义，门静脉血栓是患者术后1年内再出血的独立危险因素。
Objective: To investigate the effect of C-reactive protein/albumin ratio on postoperative rebleeding in cirrhotic patients with esophageal and gastric varices bleeding. Methods: The retrospective cohort study included 70 patients who underwent ESVD at the affiliated Hospital of Qingdao University from May 2018 to December 2022. According to the C-reactive protein/albumin ratio within three days before surgery, the patients were divided into high-CAR group and low-CAR group, The rebleeding rate within 1 year after surgery was compared between the two groups, and the risk factors for rebleeding within 1 year after surgery were analyzed. Results: The rebleeding rate within 1 year after surgery was 36.8% (7/19) in the high CAR group and 60.8% (31/51) in the low CAR group, with no statistical significance between the two groups (Log-rank P = 0.120).Multivariable analysis identified that portal vein thrombosis (HR = 2.19, 95%CI: 1.15~4.20, P = 0.018) was an independent risk factor for rebleeding within 1 year after surgery. Conclusions: The data suggested that CAR have no significant clinical significance in reducing the risk of rebleeding at one year. Furthermore, PVT was an independent factor with a significant influence on the risk for rebleeding in these patients.