血清尿素氮水平与上消化道出血关系的研究  

Research on Relationship of Serum Urea Nitrogen Level and Upper Gastrointestinal Bleeding

作　　者：郝婷婷[1] 温彦丽[1] 戴光荣[1] 冯义朝[1] 张莉[2] 李华[2] 马晓鹏[1] 

机构地区：[1]延安大学附属医院消化内科,陕西延安716000 [2]西安交通大学第二附属医院消化科,西安710000

出　　处：《现代检验医学杂志》2017年第3期86-88,91,共4页Journal of Modern Laboratory Medicine

基　　金：陕西省自然科学基础研究计划项目(2012JQ4016);西安交通大学基本科研业务费(Xjj2012072)资助

摘　　要：目的探讨上消化道疾病患者血液中尿素氮(BUN)水平高低与上消化道出血的关系。方法选择2012年1月~2015年1月上消化道疾病的116例患者为研究对象,根据血液中尿素氮水平将患者分成高BUN组和低BUN组,其中高BUN组患者76例,低BUN组患者40例,比较两组患者生化指标,并进行单因素logistic回归分析,并比较两组患者的消化道出血forrest分级与疾病严重程度的情况。结果高BUN组患者血清白细胞计数、尿素氮、肌酐以及糖化血红蛋白水平[(9 593±5 012)×10~2/μl,368.1±162.3 mg/L,11.2±3.7 mg/L和6.38%±1.08%]显著高于低BUN组患者[(6 804±2 087)×10~2/μl,121.0±39.3 mg/L,8.1±3.2 mg/L和5.51%±0.42%;t=3.645~12.659,P均<0.05)],高BUN组患者血红蛋白水平(87.3±35.1 g/L)显著低于低BUN组患者(108.0±31.2 g/L;t=3.252,P=0.032);logistic回归分析显示两组患者血红蛋白及糖化血红蛋白水平存在显著差异(P<0.05),表明血红蛋白及糖化血红蛋白与BUN相关性最大;两组患者消化道出血forrest分级数据比较差异无统计学意义(P>0.05);高BUN组患者胃溃疡比例显著高于低BUN组患者(X^2=39.655,P=0.000)。结论血清尿素氮高表达的患者上消化道出血更为严重,值得临床诊断过程中加以关注。Objective To examine characteristics of patients with blood urea nitrogen （BUN） levels higher and lower than the normal limit. Methods During January 2012 to January 2015,116 patients with upper gastrointestinal diseases were selected to study,according to the patient＇s blood urea nitrogen level, all the patients were divided into high BUN group and low BUN group,and there were 76 patients in the high BUN group,and 40 patients in low BUN group,compared the biochemical indices,gastrointestinal bleeding forrest grading and disease severity of the two groups,and univariate logistic regression analysis. Results The serum white blood cell count,blood urea nitrogen,creatinine and glycated hemoglobin levels in patients of high BUN group [（9 593±5 012） ×10^2/μl,368.1±162.3mg/L,11.2±3.7 mg/L and 6.38±1.08%] were significantly higher than that of low BUN patients [（6 804±2 087） ×10^2/μl,121.0±39.3 mg/L,8. 1±3.2 mg/L and 5.51±0.42%]（t =3. 645±12. 659,all P〈0.05） ,and the hemoglobin levels （87.3±35.1g/L） of the patients in high BUN group was significant.ly lower than that of the low BUN patients （108.0±31.2 g/L） （t= 3. 252, P= 0. 032）. Logistic regression analysis showed the presence of hemoglobin and glycosylated hemoglobin levelst of wo groups of patients was significantly different （P〈0.05）, and showed that showed the highest correlation with BUN. Gastrointestinal bleeding forrest hierarchical data of the two groups of patients showed no significant difference （P〈0.05）. The proportion of patients with gastric ulcers of high BUN patients was significantly higher than that of the low BUN patients （X^2 = 39. 655, P= 0. 000）. Conclusion Patients with high expression of serum urea nitrogen had more severe upper gastrointestinal bleeding,and it is worthy of attention in the process of clinical diagnostic.

关 键 词：血尿素氮 血红蛋白 白细胞计数 上消化道出血 

分 类 号：R573.2[医药卫生—消化系统] R446.112[医药卫生—内科学]