【摘要】 目的探究重症高血压脑出血并发应激性胃溃疡影响因素及胃泌素(GAS)、胃动素(MTL)、生长抑素(SS)、胆囊收缩素(CCK-8)、血管活性肠肽(VIP)水平变化意义。方法选取226例重症高血压脑出血患者作为研究对象,统计应激性胃溃疡发生率,对比重症高血压脑出血并发应激性胃溃疡与未并发应激性胃溃疡患者GAS、MTL、SS、CCK-8、VIP水平,并分析并发应激性胃溃疡影响因素及其预测价值。结果 226例重症高血压脑出血患者中52例发生应激性胃溃疡,发生率为23.01%(52/226);入院第3、7 d,并发胃溃疡组患者GAS、MTL、CCK-8、VIP水平均高于未并发胃溃疡患者,SS水平低于未并发胃溃疡患者(P<0.05);Logistic回归分析显示,脑干出血、脑出血量≥20 mL、颅内压增高、GCS评分<8分、GAS、MTL、CCK-8、VIP均为重症高血压脑出血并发应激性胃溃疡危险因素,SS则为保护因素;ROC曲线分析,入院第7 d GAS、MTL、SS、CCK-8、VIP预测AUC大于入院第3 d。结论脑干出血、脑出血量≥20mL、颅内压增高、GCS及GAS、MTL、SS、CCK-8、VIP均为重症高血压脑出血并发应激性胃溃疡患者影响因素,脑出血发生后密切监测GAS、MTL、SS、CCK-8、VIP水平,可预测应激性胃溃疡的发生。更多还原

【Abstract】 Objective To investigate the influencing factors of stress-induced gastric ulcer in severe hypertensive cerebral hemorrhage,and the significance of changes in gastrin(GAS),motilin(MTL),somatostatin(SS),cholecystokinin(CCK-8) and vasoactive intestinal peptide(VIP) levels.Methods A total of 226 patients with severe hypertensive cerebral hemorrhage were enrolled as the study subjects.The incidence of stress gastric ulcer was statistically analyzed,the levels of GAS,MTL,SS,CCK-8,and VIP in patients with severe hypertensive cerebral hemorrhage with stress gastric ulcer and those without stress gastric ulcer were compared,the influencing factors of concurrent stress gastric ulcers and the predictive value of GAS,MTL,SS,CCK-8 and VIP levels were analyzed.Results Among 226 patients with severe hypertensive intracerebral hemorrhage,52 cases had stress gastric ulcer,the incidence rate was 23.01%(52/226);On the third and seventh day of admission,the levels of GAS,MTL,CCK-8,and VIP in patients with gastric ulcer were higher than those without gastric ulcer,and SS levels were lower than those without gastric ulcer(P<0.05);Logistic regression analysis showed that brain stem hemorrhage,cerebral hemorrhage volume≥20 mL,increased intracranial pressure,GCS score <8 points,GAS(on the third and seventh day of admission),MTL,CCK-8 and VIP are risk factors for severe hypertensive cerebral hemorrhage and stress gastric ulcer,SS is a protective factor;ROC curve analysis,on the seventh day of admission,GAS,MTL,SS,CCK-8,VIP predicted AUC was greater than the third day of admission.Conclusion Brain stem hemorrhage,cerebral hemorrhage≥20 mL,increased intracranial pressure,GCS and GAS,MTL,SS,CCK-8,and VIP are all influential factors in patients with severe hypertensive cerebral hemorrhage and stress gastric ulcer,the levels of GAS,MTL,SS,CCK-8,and VIP after the occurrence of cerebral hemorrhage are closely monitored can predict the occurrence of stress gastric ulcers.更多还原