消化性溃疡并发出血危险因素的病例对照研究

目的　研究非甾体类抗炎药 (NSAIDs )服用史、幽门螺杆菌 (HP)感染、年龄、性别、既往出血史、吸烟等因素对消化性溃疡出血的影响。方法　对 340例消化性溃疡 (Pu)患者进行病例对照研究 ,通过Logistic回归模型进行单因素和多因素分析 ,评价上述各因素与Pu并发出血间的关系。结果　服用NSAIDs(OR 5 .32 ;95 %CI 3.0 5～ 9.2 7)、高龄 (OR 2 .71;95 %CI 1.6 5～ 4 .4 6 )、既往出血史 (OR 2 .32 ;95 %CI 1.2 3～ 4 .38)、吸烟 (OR 2 .2 0 ;95 %CI 1.31～ 3.74 )是Pu出血的高危因素 ;而HP感染 (OR 0 .90 ;95 %CI 0 .5 6～ 1.4 5 )及性别因素 (OR 1.15 ;95 %CI0 .6 8～ 1.92 )与Pu并发出血间无明显关系 ,但HP感染与服用NSAIDs间有明显的协同效应 (OR 6 .30 ;95 %CI2 .79～ 14 .2 3)。结论　服用NSAIDs、高龄、既往出血史、吸烟是Pu并发出血的重要危险因素 ,HP感染及性别因素对Pu并发出血无明显影响 ,但HP感染可以增加服用NSAIDs引发溃疡出血的危险

Risk factors of peptic ulcer bleeding:a case-control study

Objective To evaluate the effects of nonsteroidal anti inflammatory drugs(NSAIDs),helicobacter pylori(HP) infection,age,gender,previous peptic ulcer bleeding and smoking habits on the frequency of peptic ulcer bleeding.Methods Data obtained in a large case control study of 340 patients of peptic ulcer were analysed by logistic regression with calculation of odds ratios(OR) and 95% of confidence intervals(95%CI). Results From a logistic regression modle,NSAIDs (OR 5.32; 95%CI 3.05～9.27),older age(OR 2.71; 95%CI 1.65～4.46),previous peptic ulcer bleeding(OR 2.32; 95%CI 1.23～4.38) and smoking habits (OR2.20;95%CI 1.31～3.74) were relevant risk factors for bleeding.No relationship was found between HP infection(OR 0.90; 95%CI 0.56～1.45) or gender(OR 1.15; 95%CI 0.68～1.92) and peptic ulcer bleeding.However there was a synergistic interation (OR 6.30; 95%CI 2.79～14.23) of HP infection and NSAIDs on the frequency of peptic ulcer bleeding.Conclusion The use of NSAIDs,older age,previous peptic ulcer bleeding and smoking habits were all important risk factors of peptic ulcer bleeding,except HP infection or gender.However ,HP infection enhanced bleeding risk in the presence of NSAIDs.