冠心病PCI术后患者上消化道出血危险因素探讨  

Risk Factors of Upper Gastrointestinal Bleeding in Patients with Coronary Heart Disease After PCI

作　　者：郝晋瑶 程德均 王科程 HAO Jinyao;CHENG Dejun;WANG Kecheng(Hanzhong 3201 Hospital, Shanxi Hanzhong 723000, China)

机构地区：[1]陕西省汉中市三二〇一医院心血管内科,陕西汉中723000

出　　处：《河北医学》2021年第5期840-845,共6页Hebei Medicine

基　　金：陕西省社会发展科技攻关项目,(编号:2015SF239)。

摘　　要：目的:探讨冠心病经皮冠状动脉介入术(PCI)后患者上消化道出血的危险因素。方法:回顾性分析2015年6月至2019年6月医院收治的接受PCI治疗的1960例冠心病患者的资料,术后随访1年,统计上消化道出血的发生率,将发生上消化道出血的患者记为发生组,未发生上消化道出的血患者记为未发生组,对比2组患者基本资料,通过Logistic多因素分析确定PCI术后上消化道出独立危险因素。结果:随访1年,1960例冠心病PCI术后患者共有20例发生上消化道出血,发生率为1.07%;单因素分析显示,2组性别、吸烟史、饮酒史、合并症、冠心病发病至就诊时间、PCI术后用药、病变支数、病变位置、狭窄程度的比例以及血红蛋白、血小板计数差异无统计学意义(P>0.05),年龄、既往消化道病史、慢性肾功能不全、急性心肌梗死病史的比例以及PCI手术时间和肌酐清除率差异有统计学意义(P<0.05);Logistic多因素分析显示,年龄>60岁、既往消化道病史、慢性肾功能不全、急性心肌梗死病史、PCI手术时间>90min和肌酐清除率≤60mL/min均是影响冠心病PCI术后患者上消化道出血的独立危险因素。结论:冠心病PCI术后患者具有发生上消化道出血的风险,且年龄>60岁、既往消化道病史、慢性肾功能不全、急性心肌梗死病史、PCI手术时间>90min和肌酐清除率≤60mL/min均是影响冠心病PCI术后患者上消化道出血的独立危险因素。Objective:To investigate the risk factors of upper gastrointestinal bleeding in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods:The data of 1960 patients with coronary heart disease admitted to our hospital from June 2015 to June 2019 and treated by PCI were retrospectively analyzed.In the follow-up of 1 year after surgery,the incidence of upper gastrointestinal bleeding was counted,patients with upper gastrointestinal bleeding were recorded as the occurrence group,and patients without upper gastrointestinal bleeding were recorded as the non-occurring group,the basic data of the two groups were compared,and the independent risk factors for upper gastrointestinal tract after PCI were determined by Logistic multivariate analysis.Results:In the follow-up of 1 year,a total of 20 cases of 1960 coronary heart disease patients after PCI had upper gastrointestinal bleeding,the incidence was 1.07%.Univariate analysis showed that there were no significant difference in the proportions of gender,smoking history,drinking history,comorbidities,time from onset of coronary heart disease to consultation,medication after PCI,diseased branches,location of the lesion,degree of stenosis,hemoglobin,and platelet count between the two groups(P>0.05),there were statistically significant differences in the proportions of age,past history of digestive tract disease,chronic renal insufficiency,history of acute myocardial infarction,PCI operation time and creatinine clearance(P<0.05).Logistic multivariate analysis showed that age>60 years old,past history of digestive tract disease,chronic renal insufficiency,history of acute myocardial infarction,PCI operation time>90 min and creatinine clearance≤60 mL/min all affect the upper digestion of patients with coronary heart disease after PCI independent risk factors for tract bleeding.Conclusion:Patients with coronary heart disease after PCI are at risk of upper gastrointestinal bleeding,and older>60 years old,past gastrointestinal medical history,chr

关 键 词：冠心病 经皮冠状动脉介入术 上消化道出血 危险因素 

分 类 号：R54[医药卫生—心血管疾病]