Risk Factors Of Acute Upper Gastrointestinal Hemorrhage With Myocardial Injury

Objective:The patient could occur myocardial injury who has acute upper gastrointestinal bleeding,this research will improve clinicians' knowledge about atypical chest pain symptoms and guide the application of hemostatic drugs to ameliorate the patient of gastrointestinal bleeding's prognosis to reduce the fatality via the risk factor analysis of acute upper gastrointestinal bleeding with myocardial injury.Methods:(1)Research Object: This is a cross-sectional observational research,retrospective collection 110 patients of AUGIB in our hospital's gastroenterology from January 2018 to December 2019.(2)Research Method:According to the standard of myocardial injury,we divide the patient of AUGIB into combined myocardial injury group and non-myocardial injury group.Collecting the data of general clinical(age,gender,have the history of smoking or not,have the history of hypertension and cirrhosis or not,taking non-steroidal anti-inflammatory drugs or not,systolic pressure,diastolic pressure),laboratory inspection(blood routine examination,coagulation routine,blood biochemistry,myocardial injury markers),electrocardiogram,helicobacter pylori detection,gastroscopy and other related examinations.(3)Statistical analysis:Use the software of SPSS22.0 to statistical analysis,if the measurement data conform the normal distribution as mean±standard deviation,independent the sample t test was used for inter-group comparison;count data and rank data are expressed as percentage,the x~2 test and rank sum test were used in the comparison between groups;the indexes with significant difference in single factor analysis were included in logistic regression for multivariate analysis,P<0.05 was statistically significant.Results:(1)Comparison of general clinical data: The age of the myocardial injury group was 62.22 ± 12.73 years old,and the age of the non-myocardial injury group was 57.00 ± 11.16 years old.The difference between the two groups was statistically significant(P <0.05).25 cases of myocardial injury combined with hypertension history,8 cases of non-myocardial injury group,there were significant statistical differences between the two groups;myocardial injury group diastolic pressure was 68.25 ± 9.74 mmHg,non-myocardial injury group diastolic pressure was 78.65 ± 8.93 mmHg The difference between the two groups was statistically significant(P <0.05).(2)Comparison of laboratory examination results: the lowest value of hemoglobin in the myocardial injury group was 73.02 ± 14.52 g / L,the non-myocardial injury group was 87.58 ± 28.11 g / L,there was a significant statistical difference(P <0.05);the myocardial injury group albumin was 30.83 ± 15.74 g / L,33.27 ± 5.43 g / L in the non-myocardial injury group,the difference between the two groups was statistically significant(P <0.05);the median creatinine in the myocardial injury group was 81.00 umol / L,not myocardium The injury group was 71.00 umol / L,the difference between the two groups was statistically significant(P <0.05);the median urea nitrogen in the myocardial injury group was 12.94 mmol / L,and the non-myocardial injury group was 9.08 mmol / L,the two groups The difference between them was statistically significant(P <0.05).(3)Multivariate logistic regression analysis.The previous history of hypertension was an independent risk factor for gastrointestinal bleeding combined with myocardial injury.The diastolic blood pressure and the minimum value of hemoglobin were negatively correlated with myocardial injury,and urea nitrogen was positively correlated with myocardial injury.An independent risk factor for tract bleeding combined with myocardial injury.Conclusion:(1)Age is a risk factor for myocardial injury in patients with upper gastrointestinal hemorrhage.The older the age,the higher the risk of myocardial injury.(2)Hematocrit,albumin,and creatinine may be risk factors for acute GIB combined with myocardial injury.(3)The previous history of hypertension,diastolic blood pressure,hemoglobin,and urea nitrogen are independent risk factors for acute upper gastrointestinal hemorrhage with myocardial injury.