查詢結果分析
相關文獻
- Predictive Risk Factors for Upper Gastrointestinal Bleeding with Simultaneous Myocardial Injury
- 食道結核:罕見的上消化道出血原因--病例報告
- Sources and Outcome of Upper Gastrointestinal Bleeding in Patients With Portal Hypertension Manifested by Esophageal Varices
- 上消化道出血之處理
- 小兒上消化道出血之泛內視鏡所見
- Endoscopy for Upper Gastrointestinal Bleeding at Emergency Unit
- 主動脈腸道瘻管--臨床罕見之上消化道出血:二病例報告
- ECG and Cardiac Enzyme Changes Related to a Right-sided Pneumothorax--A Case Report
- 使用腸衣錠或鹼性緩衝劑型的阿斯匹靈對引發上消化道出血的危險性
- 心肌酵素CPK的檢驗在急性心肌梗塞症(AMI)之臨床意義
頁籤選單縮合
題 名 | Predictive Risk Factors for Upper Gastrointestinal Bleeding with Simultaneous Myocardial Injury=急性上消化道出血患者併發心肌受損之危險因子探討 |
---|---|
作 者 | 吳宜珍; 余方榮; 周俊仁; 林增記; 陳漢文; 李智雄; 吳登強; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 23:1 2007.01[民96.01] |
頁 次 | 頁8-16 |
分類號 | 415.5 |
關鍵詞 | 心肌受損; 心肌酵素; 上消化道出血; Myocardial injury; Troponin I; Upper gastrointestinal bleeding; |
語 文 | 英文(English) |
中文摘要 | 本研究的目的在評估急性上消化道的病患,併發心肌受損的發生率並找出可預測的危險因子。共有 155 名至高醫急診求診且主診斷為上消化道出血的病患同意參與本研究 (男性 101 人,女性 54 人;平均年齡 64.7 ± 10.4歲,分佈區間 38–94 歲),他們均接受一系列心電圖及心肌酵素 (CPK、CK-MB、TnI) 的追踪;除了拒絕或不適合者,絕大多數病患均在 24 小時內接受緊急胃鏡。輕度心肌受損定義為出現典型心電圖 ST-T 變化、CK-MB > 12U/L 或 TnI > 0.2 ng/dL 三項中任一項;中度心肌受損定義為上述三項中曾出現任二項異常者。依此定義,共有 51 人 (32.9%) 發生輕度心肌受損,12 (7.74%) 發生中度心肌受損。心肌受損在食道靜脈瘤出血的患者 (20/25 = 80.0%) 較潰瘍出血的患者 (23/112 = 20.5%) 常見;此現象無法排除與肝硬化患者可能有較高的基準 TnI 值有關。在校正過單變項分析有意義的因子後發現,潰瘍出血患者若有肝硬化病史或有超過三項冠心症危險因子者,是併發心肌受損的高危險群。其他因子包括年齡、性別、鼻胃管沖洗液的顏色、是否曾使用非類固醇止痛劑、 vasopressin 或 terlipressin、到急診時的生命徵象及肌肝酸值均非有意義的危險因子。而併發心肌受損者比單純出血者平均住院時數較長 (8.73 ± 6.94 vs. 6.34 ± 2.66 天;p = 0.03),且需要接受較多的濃縮紅血球輸注。 |
英文摘要 | The aims of this study were to: (1) evaluate the epidemiology of simultaneous upper gastrointestinal bleeding (UGIB) and myocardial injury using parameters including troponin I (TnI); and (2) investigate the predictive risk factors of this syndrome. One hundred and fifty-five patients (101 men, 54 women; mean age, 64.7 ± 10.4 years; range, 38–94 years) at the emergency department (ED) with the major diagnosis of UGIB were included. They underwent serial electrocardiography (ECG) and cardiac enzyme follow-up. Emergent gastroendoscopy was performed within 24 hours in most patients except for those who refused or were contraindicated. Mild myocardial injury was defined as the presence of any of the following: typical ST-T change on ECG, elevated creatine kinase-MB (CK-MB) > 12 U/L, or TnI > 0.2 ng/dL. Moderate myocardial injury was defined as the presence of any two of the previously mentioned conditions. In total, 51 (32.9%) and 12 (7.74%) patients developed mild and moderate myocardial injuries, respectively. Myocardial injury was more common among patients with variceal bleeding (20/25 = 80.0%) than those with ulcer bleeding (23/112 = 20.5%). It could partially be attributed to a higher baseline TnI level in cirrhotic patients. After adjusting for significant risk factors revealed by the univariate analysis, UGIB patients with a history of liver cirrhosis and more than three cardiac risk factors comprised a high-risk group for simultaneously developing myocardial injury. Other factors including age, gender, the color of nasogastric tube irrigation fluid, history of nonsteroidal anti-inflammatory drug use, vasopressin or terlipressin administration, vital signs, and creatinine recorded at the ED were not significant predictors. Those who developed myocardial injury had a longer hospital stay (mean duration, 8.73 ± 6.94 vs. 6.34 ± 2.66 days; p = 0.03) and required transfusion of more units of packed erythrocytes. |
本系統中英文摘要資訊取自各篇刊載內容。