Clin Gastroenterol H:急性严重胃肠道出血与血栓栓塞和死亡风险增加有关!

2017-06-18 xing.T MedSci原创

由此可见,在日本接受内镜检查的患者进行的回顾性分析中,研究人员发现急性GIB是晚期血栓栓塞和死亡的一个显著危险因素,相比于无GIB的患者。与普通人群相比,GIB患者也增加了死亡风险。

近日,消化病领域权威杂志Clinical Gastroenterology and Hepatology发表了一篇研究文章,研究人员在患有和无胃肠道出血(GIB)的患者中进行了一项回顾性队列研究来确定GIB是否会增加血栓栓塞和死亡的风险。

研究人员收集了522例急性重型GIB和1044例无GIB(对照者,匹配的年龄、性别、诊断时间、血栓栓塞病史和使用抗血栓药物)的数据,这些患者于2009年1月到2014年12月期间在日本全球健康和医学国家中心接受了内镜检查。研究人员估计了针对血栓栓塞和死亡风险的GIB的风险比(HR),调整了混杂因素。研究人员也比较了GIB患者队列和年龄和性别匹配的一般人群的标准化死亡率。

在平均随访23.7个月期间,11.5%的GIB患者发生血栓栓塞,而对照组只有2.4%(HR为5.3;95%可信区间为3.3-8.5;P<001)。多因素分析显示GIB作为所有的血栓栓塞事件、脑血管事件和心血管事件的一个危险因素。在平均随访24.6个月期间,15.9%的GIB患者与8.6%的对照者发生死亡(HR为2.1;95%可信区间为1.6-2.9;P<001)。多因素分析显示GIB作为全因死亡率的一个危险因素。与普通人群相比,GIB患者的死亡风险增加(标准化死亡率为12)。

由此可见,在日本接受内镜检查的患者进行的回顾性分析中,研究人员发现急性GIB是晚期血栓栓塞和死亡的一个显著危险因素,相比于无GIB的患者。与普通人群相比,GIB患者也增加了死亡风险。

原始出处:

Naoyoshi Nagata,et al. Acute Severe Gastrointestinal Tract Bleeding is Associated with an Increased Risk of Thromboembolism and Death. Clinical gastroenterology and hepatology 2017. http://www.cghjournal.org/article/S1542-3565(17)30735-8/fulltext

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    2017-11-22 许安
  4. 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    2017-06-24 大爰

    学习了谢谢分享!

    0

  5. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Mon Jun 19 07:13:19 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212577, encodeId=76692125e75b, content=感谢小编为我们精心准备了如此精辟的精神大餐,小编辛苦了,点个赞吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Jun 19 06:54:40 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212408, encodeId=4ea821240891, content=学习啦!谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 18 19:01:52 CST 2017, time=2017-06-18, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1711085, encodeId=106c1e11085a1, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Feb 19 08:45:00 CST 2018, time=2018-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064133, encodeId=80832064133a0, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Dec 21 21:45:00 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071807, encodeId=965620e1807ca, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Nov 22 16:45:00 CST 2017, time=2017-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214655, encodeId=21dc21465531, content=学习了谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Mon Jun 19 07:13:19 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212577, encodeId=76692125e75b, content=感谢小编为我们精心准备了如此精辟的精神大餐,小编辛苦了,点个赞吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Jun 19 06:54:40 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212408, encodeId=4ea821240891, content=学习啦!谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 18 19:01:52 CST 2017, time=2017-06-18, status=1, ipAttribution=)]
    2017-06-19 大爰

    学习并分享!!!

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1711085, encodeId=106c1e11085a1, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Feb 19 08:45:00 CST 2018, time=2018-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064133, encodeId=80832064133a0, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, 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channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83320, encryptionId=339e8332035, topicName=胃肠道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Jun 20 05:45:00 CST 2017, time=2017-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1390962, encodeId=9a67139096206, content=<a href='/topic/show?id=6e618332871' target=_blank style='color:#2F92EE;'>#胃肠道出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83328, encryptionId=6e618332871, topicName=胃肠道出血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6a2500070, createdName=124987a0m66(暂无昵称), createdTime=Tue Jun 20 05:45:00 CST 2017, time=2017-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212599, encodeId=1bfc21259928, content=学习并分享!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Mon Jun 19 07:13:19 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212577, encodeId=76692125e75b, content=感谢小编为我们精心准备了如此精辟的精神大餐,小编辛苦了,点个赞吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Jun 19 06:54:40 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212408, encodeId=4ea821240891, content=学习啦!谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 18 19:01:52 CST 2017, time=2017-06-18, status=1, ipAttribution=)]
    2017-06-19 ylzr123

    感谢小编为我们精心准备了如此精辟的精神大餐,小编辛苦了,点个赞吧!

    0

  10. 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channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83320, encryptionId=339e8332035, topicName=胃肠道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Jun 20 05:45:00 CST 2017, time=2017-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1390962, encodeId=9a67139096206, content=<a href='/topic/show?id=6e618332871' target=_blank style='color:#2F92EE;'>#胃肠道出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83328, encryptionId=6e618332871, topicName=胃肠道出血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6a2500070, createdName=124987a0m66(暂无昵称), createdTime=Tue Jun 20 05:45:00 CST 2017, time=2017-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212599, encodeId=1bfc21259928, content=学习并分享!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Mon Jun 19 07:13:19 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212577, encodeId=76692125e75b, content=感谢小编为我们精心准备了如此精辟的精神大餐,小编辛苦了,点个赞吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Jun 19 06:54:40 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212408, encodeId=4ea821240891, content=学习啦!谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 18 19:01:52 CST 2017, time=2017-06-18, status=1, ipAttribution=)]
    2017-06-18 tanxingdoctor

    学习啦!谢谢分享

    0

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消化道出血(GIB)是全身抗凝治疗的一个常见并发症,每年全身抗凝治疗的患者有4%-6%的风险出现GIB,而由抗凝引起的大出血占死亡病例的8%-10%。然而,患者出现GIB后是否继续抗凝以及其安全性的相关研究很有限。 因此,来自哈佛大学医学院的研究者们试图研究GIB后持续抗凝的安全性和风险。研究结果表明,患者持续抗凝带来的益处可能超过GIB复发的风险。该项研究发表于The American