重症高血压脑出血患者胃液pH值、潜血、血清胃肠激素与应激性胃溃疡的关系

Relationships of pH value of gastric juice,occult blood and serum gastrointestinal hormone with stress gastric ulceRin patients with severe hypertensive intracerebral hemorrhage

目的探讨重症高血压脑出血患者入院后胃液pH值、潜血结果和血清胃肠激素水平与应激性胃溃疡的关系。方法选取368例重症高血压脑出血住院患者作为研究对象,将其分为应激性胃溃疡组85例和未发生应激性胃溃疡组283例。收集并分析患者的胃液pH值、潜血试验结果和血清胃肠激素水平等临床资料。结果单因素分析结果显示,2组患者在年龄≥60岁、性别、消化道溃疡病史、脑干出血、入院后3 d胃液pH值≤6、入院后3 d胃液潜血阳性、手术时间≥4 h方面比较,差异有统计学意义(P<0.05);2组在颅内感染、失血性休克、格拉斯哥昏迷量表评分≥8分、应用大剂量糖皮质激素方面比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,消化道溃疡病史、入院后3 d胃液pH值≤6、入院后3 d胃液潜血阳性、手术时间≥4 h和入院后3 d胃泌素、胃动素、胆囊收缩素、血管活性肠肽水平高是应激性胃溃疡发生的危险因素(校正后P<0.05)。结论对重症高血压脑出血患者而言,有消化道溃疡病史、脑干出血、手术时间≥4 h和入院后3 d胃液pH值≤6、胃液潜血阳性,血清胃泌素、胃动素、胆囊收缩素和血管活性肠肽水平升高,可增加应激性胃溃疡发病风险。

Objective To explore the relationships of pH value of gastric juice,occult blood and serum gastrointestinal hormones with stress gastric ulceRin patients with severe hypertensive intracerebral hemorrhage afteRhospital admission.Methods A total of 368 hospitalized patients with severe hypertensive intracerebral hemorrhage were selected as study objects and divided into stress gastric ulceRgroup(n=85)and no stress gastric ulceRgroup(n=283).The clinical materials such as pH value of gastric juice,occult blood test results and serum gastrointestinal hormone levels were analyzed in all the patients.Results Univariate analysis showed that there were significant differences in age≥60 years old,gender,history of peptic ulcer,brain stem hemorrhage,pH value of gastric juice≤6 at 3 days afteRadmission,positive result of occult blood of gastric juice at 3 days afteRadmission and operation time≥4 hours between the two groups(P<0.05).There were no significant differences in intracranial infection,hemorrhagic shock,Glasgow Coma Scale score≥8 points and application of high-dose glucocorticoid between the two groups(P>0.05).Multivariate Logistic regression analysis showed that history of peptic ulcer,pH value of gastric juice≤6 at 3 days afteRadmission,positive result of occult blood of gastric juice at 3 days afteRadmission,time of surgery≥4 h,high levels of gastrin,gastrin actin,cholecystokinin and vasoactive intestinal peptide at 3 days after admission were the risk factors of stress gastric ulceR(corrected P<0.05).Conclusion FoRpatients with severe hypertensive intracerebral hemorrhage,the history of peptic ulcer,brain stem hemorrhage,surgery time≥4 h,pH value of gastric juice≤6 at 3 days afteRadmission,positive result of occult blood of gastric juice,increased levels of gastrin,gastrin actin,cholecystokinin and vasoactive intestinal peptide can increase the risk of stress gastric ulcer.