2025 年第 3 期 第 20 卷

老年消化性溃疡并出血患者再出血的特点及相关危险因素分析

Analysis of the characteristics and related risk factors of rebleeding in elderly patients with peptic ulcer complicated with bleeding

作者：李奇刘子雨赵丹丹邱光伟翟惠虹

英文作者：Li Qi Liu Ziyu Zhao Dandan Qiu Guangwei Zhai Huihong

单位：首都医科大学宣武医院消化科，北京100053

英文单位：Department of Gastroenterology Xuanwu Hospital Capital Medical University Beijing 100053 China

关键词：消化性溃疡并出血后再出血；危险因素；内镜检查

英文关键词：Rebleedingafterpepticulcercomplicatedwithbleeding;Riskfactors;Endoscopicexamination

• 摘要：

• 目的 探讨老年消化性溃疡并出血患者再出血的临床特点、内镜下表现及影响因素。方法 回顾性收集2022年1月至2024年8月于首都医科大学宣武医院住院治疗的182例老年消化性溃疡并出血患者，按预后分为再出血组（12例）与无再出血组（170例）。比较2组患者一般资料、实验室检查结果、内镜下表现。采用Logistic回归分析探究老年消化性溃疡并出血患者再出血的影响因素。结果 再出血组规律性腹痛发生率高于无再出血组（P<0.05）。再出血组白蛋白水平低于无再出血组［（27±6）g/L比（32±5）g/L］（P=0.001）。再出血组Forrest分级Ⅰa~Ⅱb级、溃疡直径≥2 cm、十二指肠球后溃疡比例均高于无再出血组（均P＜0.05）。Logistic回归分析结果显示，规律性腹痛是老年消化性溃疡并出血患者再出血的独立危险因素（P<0.05），白蛋白是独立保护因素（P<0.05）。结论 规律性腹痛为老年消化性溃疡并出血患者再出血的独立危险因素，白蛋白水平为独立保护因素。

• Objective  To investigate the clinical characteristics, endoscopic findings and influencing factors of rebleeding in elderly patients with peptic ulcer complicated with bleeding. Methods A total of 182 elderly patients with peptic ulcer and bleeding who were hospitalized in Xuanwu Hospital, Capital Medical University from January 2022 to August 2024 were retrospectively collected. According to the prognosis, they were divided into rebleeding group (12 cases) and non-rebleeding group (170 cases). The general data, laboratory examination results  and endoscopic manifestations of the two groups were compared. Logistic regression analysis was used to explore the influencing factors of rebleeding in elderly patients with peptic ulcer and bleeding. Results The incidence rate of regular abdominal pain in the rebleeding group was higher than that in the non-rebleeding group (P<0.05). The albumin level in the rebleeding group was lower than that in the non-rebleeding group ［(27±6)g/L vs (32±5)g/L］(P=0.001). The proportions of Forrest grade Ⅰa-Ⅱb, ulcer diameter≥2 cm and retrobulbar ulcer in the rebleeding group were higher than those in the non-rebleeding group(all P<0.05). Logistic regression analysis showed that regular abdominal pain was an independent risk factor for rebleeding in elderly patients with peptic ulcer and bleeding (P<0.05), and albumin was an independent protective factor (P<0.05). Conclusion Regular abdominal pain is an independent risk factor for rebleeding in elderly patients with peptic ulcer and bleeding, and albumin level is an independent protective factor.