在内镜检查后,IIb级胃患者复出出血的危险因素和预测模型
Fei Wang1, Guangxi Qi2, Xue Guan1
1Department of Gastroenterology, Beijing Pinggu Hospital Beijing 101200, China.
American journal of translational research
|April 14, 2025
概括
这项研究确定了内镜治疗后胃出血 (PUB) 患者复出血的关键风险因素. 开发了一个名图模型,以帮助临床医生预测和降低再出血风险.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 医学研究 医学研究
背景情况:
- 胃出血 (PUB) 是一个重大的临床挑战.
- 内镜治疗是PUB的主要干预措施.
- 在内镜治疗后预测再出血风险对于患者管理至关重要.
研究的目的:
- 在接受内镜治疗的IIb级PUB患者中确定重新出血的独立风险因素.
- 开发和验证一个用于预测再出血风险的诺莫格拉姆模型.
主要方法:
- 对287名IIb级PUB患者进行了回顾性分析,这些患者接受了内镜治疗.
- 患者分为建模 (n=201) 和验证 (n=86) 队列.
- 通过ROC和校准曲线验证的物流回归和名ogram构造.
主要成果:
- 确定了Helicobacter pylori (Hp) 感染,D-二分体 (D-D),前列血时间 (PT),白蛋白 (ALB) 和前列腺素E2 (PGE2) 作为再次出血的独立危险因素.
- 诺莫格拉姆模型表现出很好的准确性,AUC为0.875.
结论:
- 在内镜治疗后,在IIb级PUB患者中重新出血的关键独立风险因素被确定.
- 开发的诺米图表是临床医生评估和减轻再出血风险的宝贵工具,改善了患者的治疗结果.
相关概念视频
Peptic Ulcer Disease I: Introduction
105
Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
105
Peptic Ulcer Disease II: Pathophysiology
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Peptic Ulcer Disease (PUD) is characterized by the development of ulcers in the stomach or duodenal mucosa. Its pathophysiology is complex, involving a balance between damaging and protective elements.
Damaging agents such as Helicobacter pylori, gastric acid, pepsin, and nonsteroidal anti-inflammatory drugs (NSAIDs) can weaken the mucosal defense, allowing hydrogen ions to infiltrate back and harm epithelial cells.
Damaging agents such as Helicobacter pylori, gastric acid, pepsin, and nonsteroidal anti-inflammatory drugs (NSAIDs) can weaken the mucosal defense, allowing hydrogen ions to infiltrate back and harm epithelial cells.
163
Pathophysiology of Peptic Ulcer Disease: Injurious Factors
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Peptic ulcers are sores on the stomach's inner lining and the upper small intestine, which are the result of disruptions in the mucosal layer that houses parietal cells which produce gastric acid, and chief cells which secrete pepsinogen.
In the antrum region, G cells secrete the gastrin hormone that binds to gastrin-cholecystokinin-B (CCK2) receptors on parietal and enterochromaffin-like (ECL) cells in the fundic glands. Simultaneously, the vagus nerve releases acetylcholine, which binds...
In the antrum region, G cells secrete the gastrin hormone that binds to gastrin-cholecystokinin-B (CCK2) receptors on parietal and enterochromaffin-like (ECL) cells in the fundic glands. Simultaneously, the vagus nerve releases acetylcholine, which binds...
481
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
69
Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors
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Peptic ulcer disease, commonly called PUD, represents a multifaceted condition characterized by disruptions in the lining of the gastrointestinal (GI) tract. Central to the protection of the gastrointestinal lining is the mucosal-bicarbonate barrier. This physiological defense mechanism is a formidable shield against the corrosive effects of gastric acid and pepsin secretion in the stomach. Its role is pivotal in maintaining the structural integrity of the stomach's inner lining.
317
Peptic Ulcer Disease IV: Management
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Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
51


