急性缺血性卒中患者发生院内消化道出血的危险因素分析

目的 分析急性缺血性卒中患者（acute ischemic stroke，AIS）住院期间消化道出血（gastrointestinal
bleeding，GIB）的发生率、发生时间及危险因素。
方法 本研究纳入首都医科大学附属北京天坛医院急性卒中院内并发症队列（inhospital medical
complication after acute stroke，iMCAS）研究中AIS患者。收集患者临床信息，根据住院期间是否发生
GIB分为GIB组和无GIB组，采用多因素Logistic回归模型，分析AIS患者发生GIB相关危险因素。
结果 共纳入1129例AIS患者，平均年龄58.7±12.5岁，女性230例（20.4%）。47例住院期间发生GIB，
发生率为4.2%，卒中发作至GIB确诊时间为5（3～13）d。合并肝硬化（OR 10.06，95%CI 2.44～41.38）、
高入院NIHSS评分（OR 1.13，95%CI 1.08～1.19）、高白细胞计数（OR 1.25，95%CI 1.13～1.38）、住院时
间长（OR 1.05，95%CI 1.01～1.10）是AIS患者发生消化道出血的独立危险因素。
结论 本单中心研究数据提示合并肝硬化、高入院NI HSS评分、高白细胞计数、住院时间长是AI S患
者住院期间发生GIB的独立危险因素。

Analysis of Risk Factors of Inhospital Gastrointestinal Bleeding in Patients with Acute Ischemic Stroke

Objective To analyze the frequency, occurrence time, and risk factors of gastrointestinal bleeding
(GIB) in patients with acute ischemic stroke (AIS) during hospitalization.
Methods The data of this study were from an inhospital medical complication after acute stroke
(iMCAS) cohort of Department of Neurology of Beijing Tiantan Hospital, Capital Medical
University. The relevant clinical data were collected. According to GIB occurring or not, the
patients were divided into GIB group and no-GIB group. Multivariate logistic regression analysis
was used to determine the risk factors for inhospital GIB in AIS patients.
Results In total, 1129 AIS patients were included in this study, with a mean age of 58.7±12.5
years and 230 (20.4%) females. GIB occurred in 47 (4.2%) patients and occurred at 5 (3-13) days
after stroke. Multivariate analysis showed that liver cirrhosis (OR 10.06, 95%CI 2.44-41.38), high
NIHSS score at admission (OR 1.13, 95%CI 1.08-1.19), high white blood cell counts (OR 1.25,
95%CI 1.13-1.38) and long hospital stay (OR 1.05, 95%CI 1.01-1.10) were independent risk factors
for GIB in AIS patients.
Conclusions Liver cirrhosis, high NIHSS score at admission, high white blood cell counts, and
long hospital stay were independent risk factors for inhospital GIB in AIS patients.