老年人群上消化道出血的相关危险因素调查分析

Investigation analysis on correlated risk factors of acute upper gastrointestinal bleeding in the elder population

目的探讨老年人群上消化道出血发生的相关危险因素，为早期防治上消化道出血提供依据。方法分析190例可能发生上消化道出血的病例资料，依据胃镜检查是否发生出血分为出血组（n=65）和未出血组（n=125），通过单因素和多因素分析影响上消化道出血的危险因素。结果老年急性上消化道出血发生率为34．2％（65／190）；多因素结果显示急性上消化道出血的危险因素包括年龄（0R=1．377）、胃溃疡史（OR=2．609）、十二指肠溃疡史（OR=3．203）、急性胃黏膜病变（OR=2．560）、幽门螺旋杆菌感染（OR=3．511）、服用NSAIDs（OR=4．384）和ASA药物（oR=5．568）。结论年龄、胃十二指肠溃疡病变、幽门螺旋杆菌感染、服用NSAIDs和ASA药物是老年人群发生急性上消化道溃疡的独立危险因素，有必要针对这些高危因素采取预防措施。

Objective To explore etiological and correlated risk factors of acute upper gastrointestinal bleeding in the elder population, then to provide basis for prevention and treatment of upper gastrointestinal bleeding. Methods Data of 190 pa- tients possibly with upper gastrointestinal bleeding were retrospectively analyzed, and according to gastroscopy results, 190 cases were divided into hemorrhage group （n = 65 ） and non-hemorrhage group （n = 125 ）. Then single factor and multiple factors analy- sis methods were used to analyze the risk factors of upper gastrointestinal bleeding. Results The incidence rate of upper gastro- intestinal bleeding was 34.2% （65/190） in the elder. Multiple factors analysis results showed that the risk factors included age （ OR= 1. 377 ）, gastric ulcer history （ OR = 2. 609 ）, duodenal ulcer history （ OR = 3. 203 ）, acute gastric mucosa pathological changes （ OR = 2. 560 ）, helicobaeter pylori infection （ OR = 3.511 ）, and taking NSAIDs （ OR = 4. 384 ） and ASA （ OR = 5. 568 ） drugs. Conclusion The independent risk factors of acute upper gastrointestinal bleeding in the elderly population contain age, duodenal ulcer disease, helieobacter pylori infection and taking NSAIDs and ASA drugs. We should adopt protective measures for these high risk factors.