上消化道出血发病因素及与Hp感染的临床关联研究

Study on the Pathogenesis of Upper Gastrointestinal Bleeding and Its Clinical Association with Hp Infection

目的:研究上消化道出血发病因素及与Hp感染的临床关联。方法:本次研究选取的研究对象为2016年6月-2017年6月在笔者所在医院进行治疗的上消化道出血患者200例,根据年龄大小分为对照组(中青年患者)、观察组(老年患者),各100例。再根据非甾体类抗炎药物服用时间的长短将观察组和对照组分别分为A(63例、83例)、B(15例、8例)、C(10例、4例)、D(12例、5例)四个小组。对所有患者的Hp感染情况和药物使用情况进行记录,对比各项指标。结果:观察组患者中十二指肠溃疡、食管静脉曲张所致的出血发生率低于对照组(P<0.05),胃溃疡、胃癌所致的出血发生率高于对照组(P<0.05);服用NSAIDs药物且存在Hp感染的患者OR值高于未服用NSAIDs药物但存在Hp感染、服用NSAIDs药物且无Hp感染的患者(P<0.05);分析出血发生率与NSAIDs药物使用时间可知,两组患者中D组的OR值最高,分别与B组和C组比较差异较大(P<0.05)。结论:上消化道出血的主要发病因素为消化性溃疡疾病、胃癌和食管静脉曲张,另外NSAIDs药物的使用和Hp感染参与了上消化道出血的发病过程。

Objective：To study the risk factors of upper digestive tract hemorrhage and Hp infection and clinical relevance. Method：From June 2016 to June 2017,200 patients with upper digestive tract hemorrhage treated in our hospital were divided into control group（young and middleaged patients,observation group,100 cases each） according to their age.According to nonsteroidal anti-inflammatory drugs taking the length of time will be divided into observation group and control group respectively A（63 cases,83 cases）,B（15 cases,8 cases）,C（10 cases,4 cases）,D（12 cases, 5 cases）,four groups.Hp infection and drug use in all patients were recorded and compared.Result：The incidence of bleeding caused by duodenal ulcer and esophageal varices in the observation group was lower than that in the control group（P〈0.05）.The incidence of bleeding caused by gastric cancer was higher than that of the control group（P〈0.05）,and the OR value of the patients who took NSAIDs drugs and had Hp infection was higher than that of the patients who did not take NSAIDs drugs but had Hp infection.The incidence of bleeding and the duration of NSAIDs drug use showed that the OR of group D was the highest in the two groups,and there was significant difference between group B and group C（P〈0.05）.Conclusion：The main pathogenic factors of upper gastrointestinal bleeding are peptic ulcer,gastric cancer and esophageal varicosity,and the use of NSAIDs drugs and Hp infection are involved in the process of upper gastrointestinal bleeding.