肠系膜上动脉栓塞的发生及预后危险因素分析

Analysis of risk factors for occurrence and prognosis of SMAE

目的探讨肠系膜上动脉栓塞(SMAE)发生及影响其预后的危险因素,以提高对该病的认识。方法收集2015年9月~2020年12月在某三甲医院确诊为SMAE的住院患者42例作为研究组,随机选取同期出院第一诊断为慢性胃炎患者42例作为对照组;同时根据研究组治疗结局,将其分为死亡组(n=10例)、好转组(n=32例)。收集84例住院患者资料进行统计学分析。结果伴有房颤、动脉硬化、栓塞史、腹部手术史、纤维蛋白原升高与SMAE的发生呈正相关(P<0.05)。单因素分析示高龄、有心脏疾病、存在多处血管栓塞与SMAE患者死亡呈正相关,血小板数量与SMAE患者死亡呈负相关(P<0.05)。多因素分析示血小板数量与SMAE患者死亡呈负相关(P<0.05),存在多处血管栓塞与SMAE患者死亡,为可疑危险因素(0.05<P<0.1)。结论伴有房颤、动脉硬化、栓塞史、腹部手术史、纤维蛋白原升高是发生SMAE的危险因素,血小板减少是SMAE患者死亡的危险因素,多处血管栓塞为可疑危险因素。

Objective To explore the risk factors for occurrence and prognosis of superior mesenteric artery embolism(SMAE),in order to improve the understanding of the disease.Methods A total of 42 inpatients diagnosed with SMAE in a grade A tertiary hospital from September 2015 to December 2020 were enrolled in the study group,and 42 patients discharged from hospital during the same period and initially diagnosed with chronic gastritis were randomly enrolled in the control group.At the same time,according to the treatment outcome of the study group,they were divided into death group(n=10)and improvement group(n=32).The hospitalization data of the 84 patients were collected for statistical analysis.Results Atrial fibrillation,arteriosclerosis,history of embolism,history of abdominal surgery and fibrinogen elevation were positively correlated with the incidence of SMAE(P<0.05).Univariate analysis showed that old age,heart disease and multiple vascular embolisms were positively correlated with death of patients with SMAE(P<0.05).Platelet count was negatively correlated with death of patients with SMAE(P<0.05).Multivariate analysis showed that platelet count was negatively correlated with death of patients with SMAE(P<0.05),and multiple vascular embolisms were positively correlated with death of patients with SMAE(0.05<P<0.1)and were suspected risk factors.Conclusion Atrial fibrillation,arteriosclerosis,history of embolism,history of abdominal surgery and fibrinogen elevation are the risk factors for SMAE.Thrombocytopenia is the risk factor for death of patients with SMAE,and multiple vascular embolisms are the suspected risk factor.