| 付建辉,时华云,杨珊珊.消化性溃疡患者并发上消化道出血的危险因素分析[J].中国烧伤创疡杂志,2024,(2):157~160. |
| DOI： |
| 中文关键词: 消化性溃疡 上消化道出血 饮酒 非甾体抗炎药 单核细胞趋化蛋白⁃1 影响因素 Logistic回归分析 |
| 英文关键词:Peptic ulcer Upper gastrointestinal hemorrhage Drinking Non-steroidal anti-inflammatory drugs Monocyte chemotactic protein-1 Influencing factor Logistic regression analysis |
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| 中文摘要: |
| 【摘要】 目的 分析探讨消化性溃疡 ( PU) 患者并发上消化道出血 (UGH) 的危险因素。方法 选取2021 年 4 月至 2022 年 4 月郑州市第九人民医院收治的 90 例 PU 患者作为研究对象, 收集患者性别、 年龄、 溃疡长径、 溃疡病程、 溃疡部位、 职业、 有无吸烟史、 有无饮酒史、 是否合并幽门螺杆菌感染、 入院时血清单核细胞趋化蛋白-1 (MCP-1) 水平、 入院时 CD4+水平、 入院时 CD8+ 水平、 有无高血压病史、 有无糖尿病病史、是否长时间应用非甾体抗炎药、 是否合并 UGH 等资料, 并根据患者是否合并 UGH 将其分为并发 UGH 组和未并发 UGH 组, 多因素 Logistic 回归分析 PU 患者并发 UGH 的危险因素。结果 90 例 PU 患者中 22 例 (24.44%) 患者合并 UGH, 设为并发 UGH 组; 68 例 ( 75.56%) 患者未合并 UGH, 设为未并发 UGH 组。单因素分析结果显示, 并发 UGH 组有饮酒史、 长时间应用非甾体抗炎药患者比例明显高于未并发 UGH 组 ( χ2 = 17.113、10.399, P<0.001、 P= 0.001), 血清 MCP-1 水平、 CD4+水平明显高于未并发 UGH 组 (t = 18.595、 4.757, P 均<0.001); 多因素Logistic回归分析结果显示, 有饮酒史、 长时间应用非甾体抗炎药、 血清 MCP-1 高水平、 CD4+高水平是 PU 患者并发 UGH 的独立危险因素 (95%CI 为 3.386 ~ 30.422、 1.805 ~ 14.281、 1.047 ~ 1.131、 1.098 ~1.349, P<0.001、 P= 0.002、 P<0.001、 P<0.001)。结论 PU 患者并发 UGH 与饮酒史、 非甾体抗炎药应用史以及 MCP-1 与 CD4+水平密切相关, 临床应予以重点关注, 及时根据患者具体情况采取针对性干预措施, 以预防UGH 的发生。 |
| 英文摘要: |
| 【Abstract】 Objective To analyze the risk factors for upper gastrointestinal hemorrhage (UGH) in patients with peptic ulcer (PU). Methods 90 patients with PU, admitted to The 9th People’s Hospital of Zhengzhou from April 2021 to April 2022, were selected as research subjects, and their data were collected including sex, age, ulcer long diameter, duration of ulcer, ulcer location, occupation, history of smoking and drinking, Helicobacter pylori infection, the levels of serum monocyte chemotactic protein-1 ( MCP-1), CD4+ and CD8+ on admission, history of hypertension and diabetes, long-term use of non-steroidal anti-inflammatory drugs, complication of UGH, etc. Based on whether complicated with UGH, the patients were divided into UGH complication group and non-UGH group. Multivariate Logistic regression analysiswas conducted to analyze the risk factors for UGH in PU patients. Results Among the 90 patients with peptic ulcer, 22 patients (24. 44%) were complicated with UGH, being set as the UGH complication group, and the other 68 patients (75. 56%) without UGH were set as the non-UGH group. The results of univariate analysis showed that the proportions of patients with a history of drinking and long-term use of non-steroidal anti-inflammatory drugs in the UGH complication group were significantly higher than that in the non-UGH group (χ2 = 17. 113 and 10. 399, P<0. 001, P= 0. 001), and the levels of serum MCP-1 and CD4+were significantly higher in the UGH complication group ( t = 18. 595 and 4. 757, both P <0. 001). Multivariate Logistic regression analysis showed that, the history of drinking, long-term use of non-steroidal anti-inflammatory drugs, high level of serum MCP-1 and CD4 + were independent risk factors for UGH in patients with PU (95%CI: 3. 386-30. 422, 1. 805-14. 281, 1. 047-1. 131, 1. 098-1. 349, P<0. 001, P = 0. 002, P<0. 001, P<0. 001). Conclusion The complication of UGH in PU patients is closely related to drinking history, administration of non-steroidal anti-inflammatory drugs, and levels of MCP-1 and CD4+ . Special attention and targeted interventions should be paid and taken in clinical practice based on patients’ condition in a timely fashion to prevent the occurrence of UGH. |
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