重症脑卒中并发消化道应激性溃疡出血的高危因素分析

Analysis of high-risk factors for severe stroke complicated by gastrointestinal stress ulcer bleeding

目的探讨重症脑卒中并发消化道应激性溃疡出血的发病率及相关因素,可为临床预防提供借鉴。方法选择2017年5月至2022年5月收治的487例重症脑卒中患者作为研究对象,采用单因素和多因素logistic回归分析影响重症脑卒中合并消化道应激性溃疡出血发生的独立危险因素。结果487例重症脑卒中共发生消化道应激性溃疡出血35例(观察组),其余患者452例(对照组),发生率为7.2%。经单因素分析结果表明,2组性别、文化程度、吸烟史、饮酒史比较差异无统计学意义(P>0.05);2组年龄、BMI、糖尿病、高脂血症、动脉硬化、高血压、白蛋白水平和hs-CRP比较差异有统计学意义(P<0.05)。将上述单因素分析具有统计学差异的纳入多因素logistic回归分析,年龄、BMI、糖尿病、高脂血症、动脉硬化、高血压、白蛋白水平和hs-CRP为影响重症脑卒中并发消化道应激性溃疡出血的独立危险因素(P<0.05)。结论重症脑卒中并发消化道应激性溃疡出血发病率较高,其中年龄、BMI、糖尿病、高脂血症、动脉硬化、高血压、白蛋白水平和hs-CRP为独立危险因素,临床上应加强重点预防。

Objective To investigate the incidence and influencing factors for severe stroke complicated by gastrointestinal stress ulcer bleeding,thus providing references for clinical prevention.Methods A total of 487 patients with severe stroke admitted from May 2017 to May 2022 were selected as study subjects.Univariate and multivariate logistic regression analyses were used to analyze the independent risk factors for severe stroke complicated by gastrointestinal stress ulcer bleeding.Results Among 487 patients with severe stroke,there were 35(7.2%)cases of gastrointestinal stress ulcer bleeding(observation group),and the remaining 452 patients were included in the control group.The results of univariate analysis showed that there were no significant differences in gender,education level,smoking history and drinking history between the two groups(P>0.05).There were significant differences in age,body mass index(BMI),diabetes mellitus,hyperlipidemia,arteriosclerosis,hypertension,albumin,and high-sensitive C-reactive protein(hs-CRP)between the two groups(P<0.05).The above variables with significant differences obtained in the univariate logistic analysis were included in the multivariate logistic regression analysis.It is shown that age,BMI,diabetes mellitus,hyperlipidemia,arteriosclerosis,hypertension,albumin,and hs-CRP were independent risk factors for severe stroke complicated by gastrointestinal stress ulcer bleeding.Conclusion Severe stroke is complicated by a higher incidence of gastrointestinal stress ulcers bleeding.Age,BMI,diabetes mellitus,hyperlipidemia,arteriosclerosis,hypertension,albumin,and hs-CRP are independent risk factors that should be focused on prevention clinically.