在不同年龄组的患有上胃肠道出血的患者中使用抗血栓药物
1Department of Gastroenterology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Gastroenterology research and practice
|April 12, 2024
概括
在患有上部胃肠道出血 (UGIB) 的老年患者中,恢复抗凝剂增加了再次出血的风险. 然而,抗血栓药物并没有增加死亡率. 年轻患者可以更早地安全地恢复抗凝血剂.
科学领域:
- 胃肠病学 胃肠病学
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
背景情况:
- 上部胃肠道出血 (UGIB) 是一个重要的临床挑战,特别是在老年人群中.
- 抗血栓药物对于预防血栓事件至关重要,但会带来出血风险.
- 考虑到年龄,对UGIB患者抗血栓治疗的最佳管理仍在争论中.
研究的目的:
- 研究不同年龄组的UGIB患者抗血栓药物使用的安全性和最佳时间.
- 确定UGIB患者死亡率和再出血的风险因素,重点是抗血栓治疗.
主要方法:
- 使用单中心数据库进行回顾性观察研究.
- 包括713名被诊断患有UGIB的患者.
- 对药物治疗史,恢复模式和临床结果的分析,按年龄分层.
主要成果:
- 高龄患者 (>60岁) 占队列的62.13%,整体死亡率为2.9%.
- 在老年UGIB患者中,抗血栓药物恢复没有影响住院死亡率,但抗凝固药物恢复增加了再出血风险.
- 死亡的独立风险因素包括心脏不全,肝硬化,肌酸酶和白蛋白;对于再出血,它们包括抗凝剂使用,水出血,便颜色,红血细胞,血小板和心率.
结论:
- 抗血栓药物史和UGIB后的抗血小板使用没有显著影响UGIB患者的预后.
- 虽然抗血栓剂并没有增加老年UGIB患者的死亡率,但在恢复治疗后需要仔细管理再出血风险.
- 早期恢复抗凝剂治疗对于年轻的UGIB患者来说被认为是安全的.
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