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作 者:彭虹[1]
机构地区:[1]重庆市合川区人民医院消化内科,重庆401520
出 处:《成都医学院学报》2012年第2期230-232,共3页Journal of Chengdu Medical College
摘 要:目的探讨胃十二指肠溃疡患者上消化道出血的危险因素。方法本研究纳入178例(男115例,女63例)在我院确诊为十二指肠或胃溃疡的患者,诊断采用上消化道内镜。所有患者进行非甾体类消炎药(NSAIDs)或乙酰水杨酸(ASA)治疗,冠状动脉疾病(CAD)、年龄及性别等危险因素采用χ2检验和Logistic回归分析进行评估。结果 47例患者为胃或十二指肠球部溃疡出血,平均年龄为(65.7±12.5)岁,无出血患者的平均年龄为(46.8±15.0)岁。出血患者中ASA的使用比NSAID更常见(NSAID n=18例;ASAn=26例,P=0.036)。在胃十二指肠溃疡患者中,出血的比例女性为20%,男性为28%(P=0.056)。溃疡出血的危险因素有CAD(OR:24.66,95%CI=1.7-95.8,P=0.002),ASA的使用(OR:9.67,95%CI=2.2-36.6,P=0.022),NSAIDs的使用(OR:4.63 95%CI=1.2-15.6,P=0.033),年龄(OR=11.50,95%CI=2.8-11.2,P=0.002),男性(OR:2.47,95%CI=0.9-8.7,P=0.053)。结论高龄、动脉粥样硬化、男性和非甾体抗炎药和乙酰水杨酸的使用是胃十二指肠球部溃疡患者上消化道出血的主要危险因素,其中乙酰水杨酸的使用导致胃十二指肠球部溃疡患者上消化道出血的风险最高。Objective To investigate the risk factors for upper gastrointestinal bleeding in patients with gastric or duodenal ulcer. Methods The study included 178 cases(male 1l5,female 63)of patients with duodenal or gastric ulcer diagnosed by upper gastrointestinal endoscopy in our hospital. All patients were treated by non-steroidal anti-inflammatory drugs( NSAIDs) or aeetylsalicylic acid( ASA), risk factors such as coronary artery disease ( CAD), age and gender were assessed through the chi-square test and logistic regression analysis. Results 47 cases of patients was diagnosed as gastric or duodenal ulcer bleeding, with an average age of 65.7 ± 12. 5 years old, no bleeding patients with an average age of 46. 8±15. 0 years old. ASA usage were more common than NSAID in bleeding patientsl NSAIDs n = 18 ; the ASA n = 26 eases, P = 0. 036 ). In gastric ulcer patients, the proportion of bleeding in women was 20% and in men was 28 %(P = 0. 056). Ulcer bleeding risk factors were CAD(OR:24.66, 95% CI=I. 7-95.8,P=0. 002),ASA usage(OR:9.67,95% CI=2.2-36.6,P=0. 022),NSAID usage(OR:4.63 95 % CI= 1. 2-15.6, P = 0. 033 ), age(OR = 11. 50,95 % CI = 2.8-11.2, P = 0. 002 ), male(OR : 2.47,95 % CI= 0. 9-8. 7,P= 0. 053 ). Conclusion Old age, atherosclerosis, male and non-steroidal anti-inflammatory drugs and acetyl salicylic acid usage was the major risk factors for upper gastrointestinal bleeding in the gastric and duodenal ulcer patients,the use of acetylsalicylic acid was the highest risk of gastrointestinal bleeding in patients with gastric and duodenal ulcers.
关 键 词:胃十二指肠溃疡 上消化道出血 乙酰水杨酸 非甾体类消炎药 动脉粥样硬化性冠心病
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