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慢性病患者的胃肠道出血:系统性审查和元分析
Yanshan Lin1,2, Chunqun Li1, David Waters2
1Department of Nephrology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Renal failure
|November 13, 2023
概括
胃肠道出血 (GIB) 影响约2%的慢性病 (CKD) 患者. 透析接收是关键预测因素,GIB在慢性病患者的死亡风险增加了一倍.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 胃肠道出血 (GIB) 是功能衰竭患者死亡的重要原因.
- 慢性病 (CKD) 与各种并发症的风险增加有关,包括出血事件.
研究的目的:
- 系统地审查和评估CKD患者GIB的发病率,预测因素和结果.
- 综合现有的关于GIB流行率和CKD人口中相关死亡率的证据.
主要方法:
- 对MEDLINE和EMBASE数据库的系统文献审查.
- 对22项涉及7,810,273名CKD患者的研究数据的元分析.
- 统计聚合以确定GIB比率和预测指标,包括赔率比率 (OR) 和95%置信区间 (CI).
主要成果:
- 在CKD患者中,GIB的整体发病率为2.2%;在涉及内镜的研究中,发病率达到35.8%.
- GIB的重要预测因素包括透析 (OR 14.48),老年 (OR 1.03),糖尿病 (OR 1.30),病史 (OR 1.53) 和肝硬化 (OR 1.73).
- GIB与死亡率增加两倍相关 (OR 2.12,95% CI 1.45-3.10),具有相当大的异质性 (I2 = 93%).
结论:
- 胃肠道出血是CKD患者的普遍并发症,特别是那些接受内镜检查的人.
- 透析是GIB的强有力的预测指标,突出了针对性预防策略的需要.
- GIB显著增加了CKD患者的死亡风险,强调了及时诊断和管理的重要性.
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