Abstract: Objective To investigate the incidence rate, mortality and risk factors of ischemic hepatitis secondary to esophageal and gastric varices bleeding (EGVB).Methods The clinical data of 102 patients with EGVB admitted to our hospital from January to August 2020 were retrospectively analyzed. The patients were divided into observation group and control group according to the occurrence of ischemic hepatitis. The general data, laboratory results, auxiliary examination results and clinical situation were analyzed by univariate analysis, and the statistically significant indexes were selected (P<0.05). The significant indexes were analyzed by multivariate logistic regression analysis, the incidence rate, mortality rate and risk factors of ischemic hepatitis secondary to EGVB were evaluated.Results Among 102 patients with EGVB, 14 of them complicated with ischemic hepatitis (transaminase level > 10 times the upper limit of normal value) were included in observation group, and the remaining 88 patients were included in control group. The mortality of observation group was 35.7%, which was 4.46 times higher than that of control group. The peak values of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in observation group mostly appeared on the second day after admission, which were 791.00 (555.25, 1657.5) U/L and 2541.50 (1480.50, 4594.00) U/L respectively. Univariate analysis showed that there were significant differences in ALT, AST, gamma-glutamyltranspeptidase (GGT), lactate dehydrogenase (LDH), total bilirubin (TBIL), white blood cell (WBC), platelet count, spleen length, splenic portal vein, portal vein trunk diameter, portal vein thrombosis, mortality, complicated with hepatic encephalopathy, complicated with sepsis, Child-Pugh score and ascites situation between the 2 groups (all < 0.05). Multivariate logistic regression analysis showed that liver cancer (P=0.000), white blood cell count(P=0.014), GGT (P=025), Child-Pugh grade ( P=0.050) were significantly correlated with the incidence of ischemic hepatitis secondary to EGVB.Conclusion The incidence rate of ischemic hepatitis secondary to EGVB is 13.72%, and mortality rate is 35.7%. Liver cancer (B = 4.055, OR=57.675), WBC count (B = 0.263, OR=1.300) and Child-Pugh grade (B = 1.774, OR=5.893) were the risk factors of patients with EGVB complicated with ischemic hepatitis. The incidence of ischemic hepatitis is not significantly correlated with shock (P=0.215) or anemia (P=0.280).

Key words: Ischemic hepatitis, Hypoxic hepatitis, Liver cirrhosis, Esophageal and gastric varices bleeding