老年高血压合并脑梗死患者并发应激性上消化道出血的影响因素分析  

Impact of stress-induced upper gastrointestinal bleeding in elderly patients with hypertension and cerebral infarction

作　　者：缪礁丹 周弋人 杨一帆 骆飞飞 柳华 刘力[2] MIAO Jiao-dan;ZHOU Yi-ren;YANG Yi-fan;LUO Fei-fei;LIU Hua;LIU Li(Department of Neurology,Affiliated Hospital of Southwest Jiaotong University&Chengdu Third People's Hospital,610000 Chengdu,Sichuan,China;Chengdu Fifth People's Hospital,610000 Chengdu,Sichuan,China)

机构地区：[1]西南交通大学附属医院&成都市第三人民医院神经内科,四川成都610000 [2]成都市第五人民医院,四川成都610100

出　　处：《临床消化病杂志》2024年第5期347-350,共4页Chinese Journal of Clinical Gastroenterology

基　　金：成都市科技局2021年度科研立项(No:CK2021117);成都市第三人民医院院内课题(No:CSY-YN-01-2023-062)。

摘　　要：[目的]探讨老年高血压合并脑梗死患者并发应激性上消化道出血(stress-induced upper gastrointestinal bleeding, SIUGB)的影响因素。[方法]选择老年高血压合并脑梗死患者216例,根据是否并发SIUGB分为SIUGB组(40例)与无SIUGB组(176例)。采用单因素分析影响老年高血压合并脑梗死并发SIUGB的相关因素;采用多因素Logistic回归分析影响老年高血压合并脑梗死并发SIUGB的危险因素。调查因素包括性别、年龄、体质指数(BMI)、合并糖尿病、冠心病、高血压病史、梗死范围、脑组织移位、格拉斯哥昏迷(GCS)评分、降颅压药物应用等。[结果]经单因素分析结果显示,SIUGB组与无SIUGB组性别、年龄、BMI、合并糖尿病和合并冠心病比较差异无统计学意义(P>0.05);2组高血压病史、梗死范围、脑组织移位、GCS评分和降颅压药物应用比较差异具有统计学意义(P<0.05)。将上述单因素分析差异具有统计学意义的纳入多因素分析结果显示,高血压病史、梗死范围、脑组织移位、GCS评分和降颅压药物应用为影响老年高血压合并脑梗死并发SIUGB的危险因素。[结论]老年高血压合并脑梗死并发SIUGB影响因素较多,为降低SIUGB的发生、改善患者预后,应针对上述危险因素采取预防措施。[Objective]To investigate the factors involved in stress-induced upper gastrointestinal bleeding(SIUGB)in elderly patients with hypertension and cerebral infarction.[Methods]A total of 216 elderly patients with hypertension and cerebral infarction were selected,divided into SIUGB group(40 patients)and no-SIUGB group(176 patients)according to whether they had concurrent SIUGB.Univariate analysis was used to identify the factors influencing the association between old hypertension combined with cerebral infarction complicated by SIUGB,Multivariate Logistic regression was used to analyze the risk factors affecting SIUGB complicated by hypertension and cerebral infarction in the elderly.Investigated factors included gender,age,body mass index(BMI),comorbid diabetes mellitus,comorbid coronary heart disease,history of hypertension,infarct size,infarct size,brain tissue shift,Glasgow Coma(GCS)score,and use of blood pressure lowering medications.[Results]After univariate analysis,there were no significant differences in gender,age,BMI,comorbid diabetes and comorbid CHD between the two groups(P>0.05).There were significant differences in the history of hypertension,infarct size,brain tissue displacement,GCS score,and application of blood pressure lowering drugs between the two groups(P<0.05).The results of the above univariate analysis with statistically significant differences were included in the multivariate analysis,which showed that the history of hypertension,infarct size,brain tissue displacement,GCS score,and use of blood pressure lowering drugs were the risk factors affecting the elderly patients with hypertension complicated by cerebral infarction complicated by SIUGB.[Conclusions]Elderly patients with hypertension complicated by cerebral infarction have more influencing factors of SIUGB,and preventive measures should be aimed at the above risk factors to reduce the occurrence of SIUGB and improve the prognosis of patients.

关 键 词：应激性上消化道出血 高血压 脑梗死 相关因素分析 

分 类 号：R573.2[医药卫生—消化系统]