Department of Gastroenterology, Nanchang University Affiliated Ganzhou Hospital, Ganzhou People's Hospital, Ganzhou, Jiangxi 341000, China.
Department of Gastroenterology, Nanchang University Affiliated Ganzhou Hospital, Ganzhou People's Hospital, Ganzhou, Jiangxi 341000, China; Department of Gastroenterology, Xinfeng People's Hospital, Xinfeng, Jiangxi 341000, China.
J Clin Neurosci. 2024 Sep;127:110772. doi: 10.1016/j.jocn.2024.110772. Epub 2024 Aug 6.
Gastrointestinal bleeding (GIB) is a common complication of intracerebral hemorrhage (ICH). Rate pressure product (RPP) is an objective hemodynamic index that is closely related to the prognosis of cardia-cerebrovascular disease. The purpose of this study was to investigate the relationship between RPP and GIB in ICH patients.
We retrospectively analyzed data from ICH patients admitted to the neurosurgery department of Nanchang University affiliated with Ganzhou Hospital from January 2019 to December 2021. The patients were divided into a GIB group and a non-GIB group according to whether they had GIB. Propensity score matching was used to match between the two groups. Univariate analysis was used to select factors affecting GIB, and multivariate conditional logistic regression was used to analyze the independent factors associated with GIB.
There were 1232 patients included in the study, including 182 in the GIB group and 1050 in the non-GIB group, and 182 pairs of patients were successfully matched through propensity score matching. The univariate analysis showed that high RPP, low Glasgow coma score (GCS), fibrinogen, D-dimer and PPIs were factors associated with GIB. Multivariate conditional logistic regression showed that high RPP, low GCS and urokinase were independent risk factors for GIB, and PPIs was a protective factor for GIB.
High RPP, low GCS and urokinase were independent risk factors for GIB, and PPIs was a protective factor for GIB. Patients with a high risk of developing GIB should be monitored closely. Nevertheless, multicenter prospective studies with more patients are needed to further validate the results.
胃肠道出血(GIB)是脑出血(ICH)的常见并发症。率压乘积(RPP)是一种与心脑血管疾病预后密切相关的客观血流动力学指标。本研究旨在探讨 RPP 与 ICH 患者 GIB 的关系。
我们回顾性分析了 2019 年 1 月至 2021 年 12 月南昌大学附属赣州医院神经外科收治的 ICH 患者的数据。根据是否发生 GIB,将患者分为 GIB 组和非 GIB 组。采用倾向评分匹配法进行两组间匹配。采用单因素分析筛选影响 GIB 的因素,采用多因素条件 logistic 回归分析 GIB 的独立相关因素。
本研究共纳入 1232 例患者,其中 GIB 组 182 例,非 GIB 组 1050 例,通过倾向评分匹配成功匹配 182 对患者。单因素分析显示,高 RPP、低格拉斯哥昏迷评分(GCS)、纤维蛋白原、D-二聚体和质子泵抑制剂(PPIs)是 GIB 的相关因素。多因素条件 logistic 回归显示,高 RPP、低 GCS 和尿激酶是 GIB 的独立危险因素,PPIs 是 GIB 的保护因素。
高 RPP、低 GCS 和尿激酶是 GIB 的独立危险因素,PPIs 是 GIB 的保护因素。有发生 GIB 高风险的患者应密切监测。然而,需要更多患者的多中心前瞻性研究来进一步验证结果。