上消化道溃疡伴出血患者危险因素分析

Analysis of Risk Factors of Upper Gastrointestinal Ulcer Associated with Hemorrhage

目的探讨上消化道溃疡伴出血患者危险因素。方法随机选取临沂市中医医院2015年1月—2016年12月收治的100例十二指肠溃疡、胃溃疡患者为研究对象,调查并分析患者乙酰水杨酸类药物使用情况、非甾体类抗炎药使用情况、年龄、性别、冠状动脉疾病等危险因素与上消化道溃疡伴出血的关系。结果胃镜检查发现,溃疡部位中,十二指肠溃疡最为常见,但在出血风险上,胃体溃疡38.89%显著高于十二指肠溃疡25.00%和胃窦溃疡20.00%,差异有统计学意义(χ2=4.437 2、8.588 1,P<0.05)。胃镜检查发现,17例冠状动脉疾病患者出血3例(17.65%),20例使用过乙酰水杨酸类药物患者出血15例(75.00%),16例使用过非甾体类抗炎药物患者出血10例(62.50%)。Logistics分析发现显示,冠状动脉疾病患者出血风险显著提高(P<0.05),其中危险因素为男性、年龄、非甾体类抗炎药物的使用、乙酰水杨酸类药物的使用。结论乙酰水杨酸类药物和非甾体类抗炎药物的使用、男性、动脉粥样硬化、高龄均为上消化道溃疡伴出血患者危险因素,且乙酰水杨酸类药物导致血出血风险显著高于非甾体类抗炎药物,另外冠状动脉疾病及年龄>60岁患者若使用乙酰水杨酸类药物,其出血风险较非冠状动脉疾病及年龄<60岁患者更高。

Objective This paper tries to investigate the risk factors of upper gastrointestinal ulcer with bleeding. Methods A total of 100 patients with duodenal and gastric ulcers admitted to the Linyi City Hospital of Traditional Chinese Medicine from January 2015 to December 2016 were random selected to investigate and analyze the use of acetylsalicylic acid and nonsteroidal drugs, the use of anti-inflammatory drugs, age, gender, coronary artery disease and other risk factors and upper gastrointestinal ulcer associated with bleeding. Results Gastroscopic examination revealed that duodenal ulcer was the most common site of ulceration, but the risk of bleeding（38.89%） was significantly higher in gastritis ulcers than in 25.00% in duodenal ulcers and 20.00% in antrum ulcers. The difference was statistically significant（χ^2=4.437 2, 8.588 1,P〈0.05）. Gastroscopy revealed bleeding in 3 patients（17.65%） in 17 patients with coronary artery disease, bleeding in 15 patients（75.00%） in 20 patients receiving acetylsalicylic acid, and bleeding in 16 patients with non-steroidal anti-inflammatory drugs. 10 cases（62.50%）. Logistics analysis found that the risk of bleeding in patients with coronary artery disease was significantly increased（P〈0.05）, including risk factors for men, age, use of non-steroidal anti-inflammatory drugs, the use of acetylsalicylic acid drugs. Conclusion The use of acetylsalicylic acid and non-steroidal anti-inflammatory drugs, males,atherosclerosis, and advanced age are risk factors for upper gastrointestinal ulcers with hemorrhage, and the risk of hemorrhage caused by acetylsalicylic acid is significantly higher Non-steroidal anti-inflammatory drugs, in addition to coronary artery disease and patients older than 60 years of age if using acetylsalicylic acid, bleeding risk than non-coronary disease and patients 60 years old.