78例以心绞痛为主要症状上消化道出血的临床分析

Clinical analysis of 78 cases of upper gastrointestinal bleeding who presented with angina

目的研究隐匿性上消化道出血所致心绞痛发作的影响因素。方法既往冠心病史，以心绞痛发作来急诊，并经常规粪潜血试验、血红蛋白含量测定及72小时内胃镜确诊上消化道出血的患者78例，分析有关临床状况。结果（1）年龄大于60岁、有服用非甾体抗炎药史、既往消化道溃疡史及幽门螺旋杆菌阳性者分别有84．6％、90．9％、74．4％、89．1％；（2）出血的原因为胃粘膜病变（58．9％），胃溃疡（23．1％），十二指肠溃疡（6．5％），复合性溃疡（10．3%），其他原因（1．2％）。结论部分心绞痛的患者可因隐匿性上消化道出血诱发，后者多与服用阿司匹林等非甾类抗炎药、消化道溃疡病史及年龄有关；早期诊断可避免出血加重。

Objective The influenced factors of angina due to latent upper gastrointestial bleeding. Methods The clinical information of 78 cases of upper gastrointestinal bleeding diagnosed by feces OB test, hemoglobin test,and gastroendoscopy within 72 hours,who presented with angina.Resuits （1） The percent of age（〉60 years）,the history of NSAIDs, peptic ulcer, Hp positive among 78 patients were 84.6% ,90.9% ,74.4% ,89.1%. （2） The cause of bleeding ：the injury of stomach membrane（58.9% ）,gastric ulcer（23.1% ）,duodental ulcer（6.5% ）,complicated ulcer（10.3% ）,other reasons （1.2%） o Conclusion Angina could be induced by latent upper gastrointestinal bleeding,which often related to NSAIDs ,the history of ulcer and age.Early diagnosis can avoid worsening bleeding.