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老年急性上消化道出血合并感染的临床特点与预后分析

庞秀峰, 石斌, 王缓缓, 戴晓勇, 霍玉洁, 陈永珍, 叶宥文, 朱玉琴

庞秀峰, 石斌, 王缓缓, 戴晓勇, 霍玉洁, 陈永珍, 叶宥文, 朱玉琴. 老年急性上消化道出血合并感染的临床特点与预后分析[J]. 实用临床医药杂志, 2020, 24(22): 32-35,40. DOI: 10.7619/jcmp.202022009
引用本文: 庞秀峰, 石斌, 王缓缓, 戴晓勇, 霍玉洁, 陈永珍, 叶宥文, 朱玉琴. 老年急性上消化道出血合并感染的临床特点与预后分析[J]. 实用临床医药杂志, 2020, 24(22): 32-35,40. DOI: 10.7619/jcmp.202022009
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PANG Xiufeng, SHI Bin, WANG Huanhuan, DAI Xiaoyong, HUO Yujie, CHEN Yongzhen, YE Youwen, ZHU Yuqin. Analysis on clinical features and prognosis of acute upper gastrointestinal bleeding in aged patients with co-infection[J]. Journal of Clinical Medicine in Practice, 2020, 24(22): 32-35,40. DOI: 10.7619/jcmp.202022009
Citation: PANG Xiufeng, SHI Bin, WANG Huanhuan, DAI Xiaoyong, HUO Yujie, CHEN Yongzhen, YE Youwen, ZHU Yuqin. Analysis on clinical features and prognosis of acute upper gastrointestinal bleeding in aged patients with co-infection[J]. Journal of Clinical Medicine in Practice, 2020, 24(22): 32-35,40. DOI: 10.7619/jcmp.202022009
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老年急性上消化道出血合并感染的临床特点与预后分析

  • 上海市杨浦区中心医院/同济大学附属杨浦医院 急诊科, 上海, 200090

基金项目: 

上海市卫计委科研基金项目(201840314)

详细信息

  • 中图分类号: R571;R573

Analysis on clinical features and prognosis of acute upper gastrointestinal bleeding in aged patients with co-infection

  • Emergency Department, Yangpu District Central Hospital in Shanghai, Yangpu Hospital Affiliated to Tongji University, Shanghai, 200090

摘要

    摘要
  • 摘要: 目的 分析老年急性上消化道出血(UGIB)的临床特点,以及合并感染对预后的影响。 方法 回顾性分析260例老年急性UGIB患者的临床资料,将其分为感染组及非感染组,分析老年急性UGIB患者的临床特点、病因、治疗及预后。同时将其中170例急性胃黏膜病变患者分为感染亚组和非感染亚组,分析受试者工作特性(ROC)曲线用于评估实验室指标在预测病死率的效能。 结果 感染组休克发生率、纤维蛋白原(FIB)、白细胞计数(WBC)、C反应蛋白(CRP)及降钙素原(PCT)水平高于非感染组,差异有统计学意义(P<0.05); 但2组病死率及其他因素比较,差异无统计学意义(P>0.05)。感染亚组病死率及休克发生率高于非感染亚组,活化部分凝血活酶时间(APTT)及FIB高于非感染亚组,差异有统计学意义(P<0.05)。260例老年急性UGIB患者中,血清尿素氮是唯一与全因病死率相关的独立预测变量,在急性胃黏膜病变亚组中也有较好的预测价值。 结论 老年急性UGIB的病因主要为急性胃黏膜病变,其次为肿瘤。急性胃黏膜病变合并感染的患者病死率及休克发生率较高,入院时BUN水平是全因病死率的独立预测标志物。
    Abstract: Objective To study the clinical characteristics and the influence of co-infection on prognosis of acute upper gastrointestinal bleeding(UGIB). Methods The clinical data of 260 elderly patients with acute UGIB were selected, and they were divided into infection group and non-infection group. Their clinical characteristics, etiology, treatment and prognosis were analyzed. At the same time, 170 patients with acute gastric mucosal lesions of 260 cases were divided into infected subgroup and non-infection subgroup, and receiver operating characteristic(ROC)curve was used to analyze the efficacy of laboratory indicators in predictingfatality rate. Results The incidence of shock, fibrinogen(FIB), white blood cell count(WBC), C-reactive protein(CRP)and procalcitonin(PCT)levels in the infection group were significantly higher than those in the non-infection group(P<0.05). However, there were no significant differences in fatality rate and other factors between the two groups(P>0.05). The mortality and shock rates of the infection subgroup were significantly higher than those of the non-infection subgroup, and activated partial thromboplastin time(APTT)and FIB levels were significantly higher than those of the non-infection subgroup(P<0.05). Among 260 elderly patients with acute UGIB, serum urea nitrogen was the only independent predictor associated with all-cause mortality, and was of great predictive value in the subgroups with acute gastric mucosal lesions. Conclusion The main etiology of acute UGIB in elderly patients in emergency department is acute gastric mucosal lesion, followed by tumor. Mortality and shock rates are higher in UGIB - patients with infection, and BUN level at admission is an independent predictor of all-cause mortality.
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出版历程
  • 收稿日期:  2020-09-16
  • 网络出版日期:  2020-12-21
  • 发布日期:  2020-12-02

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