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急性胰腺炎患者并发消化性溃疡的危险因素分析
Risk factors for peptic ulcer in patients with acute pancreatitis
文章发布日期:2013年06月07日  来源:  作者:廖 娟,袁 聪, 刘 娟,等  点击次数:1803次  下载次数:399次

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【摘要】:目的探讨急性胰腺炎(AP)患者并发消化性溃疡(PU)的临床特征,并分析并发PU的危险因素。方法回顾性分析2008年1月-2012年1月本院收治的156例AP患者的临床资料。所有患者入院后48 h内均进行胃镜检查,以评估其PU和幽门螺杆菌感染情况。应用Ranson评分、APACHEⅡ评分和CT严重指数评估AP严重程度。应用独立样本t检验和χ2检验对伴发PU和无PU的AP患者临床特征进行统计学分析,同时应用单因素和多因素Logistic回归分析AP患者并发PU的危险因素。结果156例AP患者中,88例患者胃镜检出PU,检出率为56.4%。88例PU患者中,只有28(31.8%)例检测到幽门螺杆菌。28例幽门螺杆菌阳性的PU患者中,22例发生胃溃疡,6例同时发生胃溃疡和十二指肠溃疡,没有发现单独的十二指肠溃疡;而60例幽门螺杆菌阴性PU患者中,25例发生胃溃疡,26例发生十二指肠溃疡,9例同时发生胃溃疡和十二指肠溃疡。单因素Logistic回归分析发现,男性、酒精源性胰腺炎、吸烟、饮酒、高甘油三酯水平和高C反应蛋白水平、APACHEⅡ评分≥8分与AP患者并发PU显著相关。然而,多因素Logistic回归分析发现,只有APACHE Ⅱ评分≥8分(OR=8.54,95%CI:4.52~16.15,P<0.01)是AP患者并发PU的独立危险因素。结论AP患者容易并发PU,而幽门螺杆菌感染率较低。APACHE Ⅱ评分≥8分是AP患者并发PU的独立危险因素。
【Abstract】:ObjectiveTo investigate the clinical characteristics of acute pancreatitis (AP) associated with peptic ulcer (PU) and to analyze the risk factors for PU in AP patients. MethodsA retrospective analysis was performed on the clinical data of 156 AP patients who were admitted to our hospital from January 2008 to January 2012. All patients underwent gastroscopy within 48 h after admission to detect PU and Helicobacter pylori (Hp) infection. The severity of AP was assessed by Ranson score, APACHE Ⅱ score, and CT severity index. The clinical characteristics of AP patients with or without PU were statistically analyzed using independent samples t-test and chi-square test. The univariate and multivariate logistic regression analyses were used to determine the risk factors for PU in AP patients. ResultsAmong the 156 AP patients, 88 (56.4%) had PU, but only 28 (31.8%) of the 88 cases were infected with Hp. Of the 28 patients, 22 had gastric ulcer, and 6 had both gastric ulcer and duodenal ulcer. Of the 60 PU patients not infected with Hp, 25 had gastric ulcer, 26 had duodenal ulcer, and 9 had both gastric ulcer and duodenal ulcer. The univariate logistic regression analysis showed that male gender, alcohol-induced pancreatitis, smoking, alcohol consumption, high triglyceride level, high C-reactive protein level, and APACHE Ⅱ score ≥8 were significantly associated with PU in AP patients. However, the multivariate logistic regression analysis showed that APACHE Ⅱ score ≥8 was the independent risk factor for PU in AP patients (OR=8.54, 95% CI: 4.52-16.15, P<0.01). ConclusionAP patients are susceptible to PU, but the infection rate of Hp is low. APACHE Ⅱ score ≥8 is the independent risk factor for PU in AP patients.
【关键字】:胰腺炎,急性坏死性;消化性溃疡;危险因素;急性病生理学和长期健康评价
【Key words】:pancreatitis, acute necrotizing; peptic ulcer; risk factors; APACHE
【引证本文】:

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