出血性卒中患者发生应激性溃疡的相关因素研究  

Stress ulcer related factors in patients with hemorrhagic stroke

作　　者：任守英 周辛平[2] 韩西娟[1] 

机构地区：[1]北京市密云县医院神经内科,北京101500 [2]北京市密云县医院老年病科,北京101500

出　　处：《临床和实验医学杂志》2016年第4期314-317,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金资助项目(编号:81273553)

摘　　要：目的探讨出血性卒中患者发生应激性溃疡(SU)的相关因素,为临床预防SU发生提供科学依据。方法回顾性分析2010年1月至2015年1月收治的出血性卒中患者695例,其中发生SU的患者80例(11.51%),将患者分为发生SU组和未发生SU组,比较两组性别比例、年龄分布、病变部位、意识情况、出血量、APACHEⅡ评分、合并出血性卒中史、合并高血压史、收缩压、阿司匹林用量10个因素的差异,确定相关影响因素以及独立影响因素。结果单因素分析结果,年龄、出血部位、意识状态、出血量、APACHEⅡ评分、SBP、阿司匹林每天的用量为出血性卒中患者发生SU的相关影响因素;多因素回归分析,出血部位(OR=3.150,P=0.001)、出血量(OR=1.957,P=0.000)、收缩压(OR=0.432,P=0.000)、阿司匹林每天用(OR=0.539,P=0.004)为出血性卒中患者发生SU的独立影响因素。结论出血量、出血部位、收缩压、阿司匹林每天用量为出血性卒中患者发生SU的独立影响因素,为了更好地预防出血性卒中患者发生SU,对于易发人群要早期给予合适的预防性药物治疗和措施。Objective To investigate the related factors of stress ulcer（ SU） in patients with hemorrhagic stroke（ HS）,in order to provide a scientific basis for clinical prevention. Methods 695 cases of hemorrhagic stroke treated from January 2010 to January 2015 were retrospectively analyzed. According to the occurrence of SU during the treatment,The patients were divided into HS ＋ SU group（ n = 80） and HS group（ n = 615）. Comparison was made between two groups for the following： gender,age,lesion location,consciousness,amount of bleeding,APACHEⅡ score,HS history,hypertension,SBP,and aspirin dosage. The related factors and independent factors were analyzed. Results Univariate analysis showed age,bleeding site,state of consciousness,bleeding amount,APACHEⅡ score,SBP and daily dosage of aspirin were the related factors of SU formation in HS patients. Multiple regression analysis indicated the site of bleeding（ OR = 3. 150,P = 0. 001）,bleeding amount（ OR = 1. 957,P = 0. 000）,SBP（ OR = 0. 432,P = 0. 000）,and daily usage of aspirin（ OR = 0. 539,P = 0. 004） were the independentfactors for SU formation in HS patients. Conclusion The amount of bleeding,bleeding site,SBP and daily aspirin dosage were independent factors for SU formation in HS patients. Appropriate preventive medication and measures should be adopted for HU patients with high- risk of SU to prevent the occurrence of SU.

关 键 词：出血性卒中 应激性溃疡 相关因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]