Analysis Of Risk Factors For Acute Recurrence Of Gout During Gastrointestinal Hemorrhage

Objective:Clinical work has found that some patients with previous history of gout may have severe pain,redness,dysfunction,fever and other symptoms of gout recurrence or aggravation during gastrointestinal bleeding,but some patients did not.Non-steroidal anti-inflammatory drugs(NSAIDs)are first-line treatments for the treatment of acute gout attacks,but these drugs can inhibit gastric mucosal damage caused by cyclooxygenase(COX),trigger or aggravate gastrointestinal bleeding,and cause the two diseases to be treated.Contradictions,treatment is relatively difficult.If you can find the risk factors for acute gout recurrence during gastrointestinal bleeding and timely preventive and intervention,it may reduce the rate of gout recurrence and improve the prognosis of patients.However,the current research on gout risk factors is mostly a study of gout population and the general population,while the study of risk factors for gout recurrence(poor control)in gout population is rare.Whether the risk factors for acute gout recurrence in this part of the patient population are consistent with the risk factors for gout in the general population,or whether there are other special risk factors are worth exploring.This study explored the risk factors for acute gout recurrence during gastrointestinal bleeding in patients with a history of gout,and is intended to assist in clinical care.Method and materials:We collected the medical records of 149 patients who were admitted to our hospital from September 2013 to August 2018 in the past.The history of gout was mainly due to gastrointestinal bleeding and the patients were not in the acute gout attack when they found gastrointestinal bleeding.Exclusion of acute gout during episode(2),severe data loss(10 cases),tumor radiotherapy and chemotherapy(2 cases),myeloproliferative disease(1 case),disturbance of consciousness(2 cases),death case(1 case)),a total of 131 cases were included.A total of 59 patients with acute recurrence of gout during hospitalization were included in the case group,and 72 patients with no recurrence of gout were used as observation groups.Basic data of the two groups of patients [age,gender,smoking history,smoking index(number ofcigarettes per day × years),history of drinking],whether or not combined with basic diseases(hypertension,diabetes,coronary heart disease,cerebral infarction,hyperlipidemia)),whether the infection,the course of gout and the frequency of attacks,the location of gastrointestinal bleeding,the estimated amount of bleeding and related treatment(whether blood transfusion and blood transfusion,PPI dosage form,fructose use),some biochemical indicators uric acid(UA),blood urea nitrogen(BUN)Creatinine(Cr),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(Alb),total cholesterol(TC),triglyceride(TG),low density lipoprotein sterol ester(LDL-C)Case-control studies were performed on high-density lipoprotein cholesterol ester(HDL-C)and fasting blood glucose(FPG).Logistic regression statistical analysis was used to screen each factor by univariate analysis,and multiple factors were statistically significant(P<0.05)or close to statistical significance(P<0.1)after univariate analysis.Result:1.Univariate analysis showed that there was a statistically significant difference between the two groups in terms of co-infection,frequency of gout,bleeding site,blood loss,blood transfusion,UA,Alb,and PPI(P<0.05).Whether blood transfusion,BUN is relatively close to statistical significance(P <0.1);2.Multivariate logistic regression analysis showed that women,smoking,co-infection,more bleeding,high level of UA,and PPI were independent risk factors for acute gout recurrence during gastrointestinal bleeding(P<0.05).Conclusion:The study found that women,smoking,co-infection,more bleeding,high UA levels,PPI dosage form were independent risk factors for acute gout recurrence during gastrointestinal bleeding in patients with previous gout history;and the frequency of previous gout attacks,digestive tract,the amount of blood transfused during the bleeding site and during hospitalization is also associated with acute recurrence of gout.