The Influence Of Infection On Esophagogastric Variceal Bleeding In Liver Cirrhosis

Objective: It has been agreed that infection is the risk factor of aggravating esophageal and gastric variceal bleeding(EGVB)in liver cirrhosis,but the factors that cause bleeding due to infection are still unclear.Therefore,through retrospective case analysis,we observed the EGVB in patients with cirrhosis and infection,and the changes of platelet count,prothrombin time,serum sodium,serum albumin,total bilirubin,red sign and Child-Pugh grade of liver function,which is aimed to explore the influence of infection on EGVB in liver cirrhosis,and provide the theoretical guidance of it for clinical prevention and treatment.Methods: A total of 185 hospitalized patients with liver cirrhosis from July 1,2015 to July 31,2019 in our hospital with complete case data were selected as the research objects,including 135 male patients and 50 female patients.The patients were divided into bleeding group(89 cases)and non bleeding group(96 cases)according to whether there was bleeding;73 cases were divided into infection group and 112 cases were not infected group.Age,gender,etiology,bleeding,infection,platelet count,prothrombin time,serum sodium,serum albumin,total bilirubin,red sign and Child-Pugh grade of liver function were compared changes in each group.Results: Between the bleeding group and the non bleeding group,in addition to infection and red signs,there was no significant difference in age,gender,etiology,platelet count,prothrombin time,serum sodium,total bilirubin and Child-Pugh grade of liver function(P<0.05).Among the infected patients,60.3%(44/73)had pulmonary infection,64.4%(47/73)were infected with bleeding,and 37.5%(42/112)were not infected with bleeding.The serum albumin and prothrombin time in the infection group decreased /prolonged compared with the non infection group(P<0.05),especially when the infection complicated with bleeding(P < 0.05).In the infected group,the proportion of Child-Pugh B+C patients reached 53.4%(39/73).Compared with 21.4%(24/112)in the uninfected group,the difference was significant(P<0.05).There was no significant difference inplatelet count,serum sodium,total bilirubin and red sign between the infected group and the uninfected group(P>0.05).Conclusion: 1.Infection and red sign are risk factors of esophageal and gastric variceal bleeding,and the risk of esophageal and gastric variceal bleeding is increased after infection.2.Infection may further aggravate the damage of liver function,reduce serum albumin and prolong prothrombin time,and thereby increasing the risk of esophageal and gastric variceal bleeding in liver cirrhosis.