维持性血液透析患者消化道出血的相关因素分析

An analysis of factors relevant to gastrointestinal hemorrhage in patients undergoing maintenance hemodialysis

目的分析维持性血液透析患者消化道出血的相关因素。方法维持性血液透析患者120例中,101例伴有消化道出血(出血组),19例未出现消化道出血(未出血组)。检测两组肾功能和凝血功能相关指标,并检测患者幽门螺杆菌(Hp)感染情况。结果出血组SCr、BUN、全段甲状旁腺激素(iPTH)及血清胃泌素(SG)水平均高于未出血组(P<0.05),而血浆白蛋白(Alb)和Hb水平低于未出血组(P<0.05)。出血组Plt、凝血酶原时间(PT)和APTT水平均高于未出血组(P<0.05),而纤维蛋白原(Fib)水平低于未出血组(P<0.05)。出血组67例Hp感染阳性,未出血组4例Hp感染阳性。维持血液透析患者消化道出血与Alb、Hb及Fib水平呈负相关(P<0.05),与SCr、BUN、iPTH、SG、Plt、PT及APTT呈正相关(P<0.05)。结论维持性血液透析患者消化道出血与肾功能和凝血功能密切相关。

Objective To analyze the factors relevant to gastrointestinal hemorrhage in the patients undergoing maintenance hemodialysis.Methods A total of 120 patients undergoing maintenance hemodialysis was divided into two groups,of whom 101 cases occurred gastrointestinal hemorrhage（group A）and 90 cases did not（group B）.Renal and coagulation functions were detected in two groups.Helicobacter pylori（Hp）infection was examined as well.Results The levels of SCr,BUN,intact parathyroid hormone serum（iPTH）and serum gastrin（SG）were higher,but the levels of plasma albumin（Alb）and Hb were lower in group A than those in group B（P〈0.05）.The levels of Plt,prothrombin time and APTT were higher,but fibrinogen（Fib）was lower in group A than those in group B（P〈0.05）.Sixty-seven cases were with positive Hp infection in group A and four cases were found to be Hp positive in group B.Gastrointestinal hemorrhage in the patients undergoing maintenance hemodialysis was negatively related to the levels of Alb,Hb and Fib,but positively correlated to the levels of SCr,BUN,iPTH,SG,Plt,PT and APTT（P〈0.05）.Conclusion Gastrointestinal hemorrhage in the patients undergoing maintenance hemodialysis is closely correlated with renal and coagulation functions.