Influence of alcohol consumption on liver function and rebleeding in alcoholic cirrhotic patients with esophageal and gastric varices / 临床肝胆病杂志

@#ObjectiveTo investigate the influence of alcohol consumption on liver function and prognosis in alcoholic cirrhotic patients. MethodsA total of 211 alcoholic cirrhotic patients with gastroesophageal variceal bleeding who underwent endoscopic treatment in Beijing Ditan Hospital, Capital Medical University, from September to December, 2018 were enrolled, and among these patients, there were 208 male and 3 female patients, with a mean follow-up time of 45 months (range 2-110 months). The association of alcohol consumption with liver parameters was analyzed. According to the presence or absence of gastroesophageal variceal rebleeding, the patients were divided into early rebleeding group, delayed rebleeding group, and non-rebleeding group, and the three groups were compared in terms of liver parameters and alcohol consumption. The t-test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. The Spearman rank correlation test was used for correlation analysis. ResultsDuration of drinking was correlated with creatinine (r=0.142, P=0.039) and direct bilirubin (DBil) (r=-0.137, P=0.047), and daily alcohol consumption was correlated with DBil (r=0.144, P=0.037) and prealbumin (r=-0.190, P=0.009), while there was no correlation between total alcohol consumption and indicators for liver injury. There were significant differences between the early rebleeding group and the delayed rebleeding group in white blood cell count (WBC) (t=-2.355, P=0.020), neutrophils (t′=-2.602, P=0.010), hemoglobin (t=2.247, P=0.026), mean corpuscular volume (t=-2.073, P=0.040), alanine aminotransferase (Z=-1.985, P=0047), international normalized ratio (Z=-2.397, P=0.017), spleen thickness (Z=-2.542, P=0.011), Child-Pugh score (t′=-2.364, P=0.020), and Child-Pugh grade (Z=-2.485, P=0.013). The non-rebleeding group had significantly lower WBC (Z=-2.276, P=0.017) and neutrophils (Z=-2.375, P=0.018) than the rebleeding group, and the early and delayed rebleeding groups had a significantly shorter duration of drinking than the non-rebleeding group (Z=-2.522, P=0.012). The logistic regression analysis showed that neutrophils was a risk factor for variceal rebleeding (odds ratio=1.152, 95% confidence interval: 1.017-1.300, P=0026). ConclusionNo dose-response relationship is found between alcohol consumption and liver injury in this study, and alcohol consumption may not have a marked effect on variceal rebleeding.