Department of Gastroenterology, Nanchang University Affiliated Ganzhou Hospital, Ganzhou, Jiangxi 341000, China.
Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
Clin Neurol Neurosurg. 2023 Aug;231:107802. doi: 10.1016/j.clineuro.2023.107802. Epub 2023 May 25.
To investigate the risk factors for gastrointestinal bleeding in patients with cerebral infarction after dual antiplatelet therapy.
Cerebral infarction patients who received dual antiplatelet therapy during January 2019 and December 2021 in Nanchang University Affiliated Ganzhou Hospital were included. Patients were divided into a bleeding group and a nonbleeding group. Propensity score matching was used to match the data between the two groups. The risk factors for cerebral infarction with gastrointestinal bleeding after receiving dual antiplatelet therapy were analyzed by conditional logistic regression.
There were 2370 cerebral infarction patients who received dual antiplatelet therapy included in the study. There were significant differences between the bleeding group and the nonbleeding group in terms of sex, age, smoking, drinking, hypertension, coronary heart disease, diabetes and peptic ulcer before matching. After matching, 85 patients were included in the bleeding group and nonbleeding group, and there was no significant difference between the two groups in terms of sex, age, smoking, drinking, previous cerebral infarction, hypertension, coronary heart disease, diabetes, gout or peptic ulcer. Conditional logistic regression analysis showed that long-term use of aspirin and severity of cerebral infarction were risk factors for gastrointestinal bleeding in cerebral infarction patients receiving dual antiplatelet therapy, whereas the use of PPI was a protective factor against gastrointestinal bleeding.
Long-term use of aspirin and severity of cerebral infarction are risk factors for gastrointestinal bleeding in cerebral infarction patients receiving dual antiplatelet therapy. The use of PPIs could reduce the risk of gastrointestinal bleeding.
探讨脑梗死患者双联抗血小板治疗后发生胃肠道出血的危险因素。
纳入南昌大学附属赣州医院 2019 年 1 月至 2021 年 12 月期间接受双联抗血小板治疗的脑梗死患者。根据是否发生出血将患者分为出血组和未出血组，采用倾向性评分匹配法对两组数据进行匹配，采用条件 logistic 回归分析脑梗死患者双联抗血小板治疗后发生胃肠道出血的危险因素。
本研究共纳入 2370 例接受双联抗血小板治疗的脑梗死患者，出血组与未出血组在性别、年龄、吸烟、饮酒、高血压、冠心病、糖尿病、消化性溃疡等方面比较，差异均有统计学意义（均 P<0.05）。匹配后，出血组和未出血组各纳入 85 例患者，两组患者在性别、年龄、吸烟、饮酒、既往脑梗死、高血压、冠心病、糖尿病、痛风、消化性溃疡等方面比较，差异均无统计学意义（均 P>0.05）。条件 logistic 回归分析结果显示，长期使用阿司匹林和脑梗死严重程度是脑梗死患者双联抗血小板治疗后发生胃肠道出血的危险因素，而使用 PPI 是胃肠道出血的保护因素。
长期使用阿司匹林和脑梗死严重程度是脑梗死患者双联抗血小板治疗后发生胃肠道出血的危险因素，使用 PPI 可降低胃肠道出血风险。
