胃食管反流病与冠心病的临床关联性研究

发布时间：2018-02-10 19:36

  本文关键词： 冠心病 胃食管反流病 危险因素 关联性　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨胃食管反流病(GERD)与冠心病的临床关联性并分析其危险因素,为临床诊治提供理论依据。方法:对2016年1月～2016年12月于辽宁省人民医院消化内科就诊的393例患者的病例进行回顾性分析。首先收集167例曾行冠状动脉造影确诊为冠心病目前于我院消化科住院的患者作为观察组(冠心病组),再收集同期于本科门诊及住院就诊的226例非冠心病患者作为对照组(非冠心病组),运用EpiData3.0录入所得资料,采用SPSS21.0软件对收集的资料进行统计分析,计数资料应用构成比、率、均数和标准差进行描述性分析,分类变量采用卡方检验进行统计推断分析。比较两组之间性别、年龄等一般情况,比较两组之间胃食管反流病的发生率情况,比较两组之间GERD患者非糜烂性反流病(NERD)、反流性食管炎(A、B级)、反流性食管炎(C、D级)、Barrett食管之间的差异;进而探讨冠心病与胃食管反流病的临床相关性,并进一步对比分析观察组(冠心病组)中合并GERD及未合并GERD两组之间在性别、年龄、BMI、阿司匹林服用史、硝酸酯类药物服用史、高血压、糖尿病等相关指标的区别,从而探讨冠心病与胃食管反流病的临床相关性,并分析冠心病患者并发胃食管反流病的危险因素。结果:1.一般情况:观察组患者年龄介于44-88岁之间,平均年龄(65.77±10.59)岁,对照组年龄介于34-87岁之间,平均年龄(63.74±11.06)岁,两组比较无差异(P0.05)。两组患者性别构成:观察组男性93例,女性74例;对照组男性117例,女性109例;两组比较性别构成无差异(P= 0.4410.05)。2.冠心病组合并胃食管反流病患者70例,占总数(167)的41.92%,非冠心病组胃食管反流病患者45例,占总数(226)的19.91%,冠心病患者GERD发病率(41.92%)高于非冠心病组GERD发病率(19.91%),差异具有统计学意义(P0.05)。3.冠心病组胃食管反流病患者中非糜烂性食管炎占42.9%,反流性食管炎A、B级占30.0%,C、D级占14.3%,Barret食管占12.9%;非冠心病组胃食管反流病患者中非糜烂性食管炎占42.2%,反流性食管炎A、B级占37.8%,C、D级占11.1%,Barret食管占8.9%,两组比较无统计学意义(P0.05)。4.对纳入研究指标进行单因素分析显示阿司匹林服用史、硝酸酯类药物服用史以及高脂血症有统计学意义,对有统计学意义的指标进行Logistic回归分析,得出高脂血症为独立危险因素。结论:1.胃食管反流病与冠心病之间存在关联性:冠心病患者胃食管反流病发生率高于非冠心病患者;2.冠心病并GERD患者与非冠心病并GERD患者比较:两组中非糜烂性反流病,反流性食管炎(A、B级),反流性食管炎(C、D级),Barrett食管构成无差异。3.阿司匹林服用史、硝酸酯类药物服用史、高脂血症可能为冠心病合并胃食管反流病的危险因素,其中高脂血症为冠心病合并胃食管反流病的独立危险因素。
[Abstract]:Objective: to investigate the clinical association between GERD and coronary heart disease and analyze its risk factors. Methods: a retrospective analysis was made of 393 patients who had been admitted to the Department of Digestive Medicine of Liaoning Provincial people's Hospital from January 2016 to December 2016. Firstly, 167 patients who had been diagnosed by coronary angiography were collected. In order to study coronary heart disease (CHD) patients in digestive department of our hospital as observation group (coronary heart disease group), and then collect 226 non-coronary heart disease patients (non-coronary heart disease group) as control group (non-coronary heart disease group), and use EpiData3.0 to input the data. SPSS21.0 software was used to analyze the collected data. The composition ratio, rate, mean and standard deviation of the counting data were analyzed in a descriptive way. The statistical inferences of the classified variables were analyzed by chi-square test. The sex of the two groups was compared. To compare the incidence of gastroesophageal reflux disease (GERD) between the two groups, and to compare the difference between the two groups in non-erosive reflux disease (NERDX), reflux esophagitis, reflux esophagitis, and reflux esophagitis, and the difference between the two groups in the incidence of gastroesophageal reflux disease (GERD). To explore the clinical correlation between coronary heart disease and gastroesophageal reflux disease (GERD), and to compare and analyze the sex, age, history of aspirin and nitrates between the two groups in the study group (coronary heart disease group) with or without GERD. To explore the clinical correlation between coronary heart disease and gastroesophageal reflux disease. The risk factors of gastroesophageal reflux disease in patients with coronary heart disease were analyzed. Results 1. General situation: the patients in the observation group were aged between 44 and 88 years, with an average age of 65.77 卤10.59 years, while those in the control group were between 34 and 87 years old, with an average age of 63.74 卤11.06 years. There was no difference between the two groups (P 0.05). The sex composition of the two groups was 93 males and 74 females in the observation group, 117 males and 109 females in the control group, and there was no difference between the two groups (P = 0.4410.05 .2.70 patients with coronary heart disease combined with gastroesophageal reflux disease), 41.92% of the total, 45 cases of gastroesophageal reflux disease in non-coronary heart disease group, The incidence of GERD in coronary heart disease patients (19.91%) was higher than that in non-coronary heart disease group (19.91%). The difference was statistically significant (P 0.05. 3). In coronary heart disease group, non-erosive esophagitis accounted for 42.9%, and reflux esophagitis grade A B accounted for 30.020%. Grade 14. 3 Barret's esophagus accounted for 12. 9; non-erosive esophagitis was 42.2 in non-coronary heart disease patients, and reflux esophagitis was 37. 8% in grade B and 11. 1% in Barret's esophagus. There was no significant difference between the two groups (P 0. 05. 4). Analysis shows that aspirin use history, The history of taking nitrate esters and hyperlipidemia were statistically significant. Logistic regression analysis was performed on the statistically significant indexes. Conclusion 1. There is a correlation between gastroesophageal reflux disease and coronary heart disease: the incidence of gastroesophageal reflux disease in coronary heart disease is higher than that in non coronary heart disease. 2. Coronary heart disease with GERD and non-coronary heart disease. And GERD patients: two groups of non-erosive reflux disease, There was no difference in the composition of Barrett's esophagus in reflux esophagitis and reflux esophagitis. The history of aspirin use, the history of nitrates and hyperlipidemia may be the risk factors of coronary heart disease complicated with gastroesophageal reflux disease. Hyperlipidemia was an independent risk factor for coronary heart disease complicated with gastroesophageal reflux disease.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R571;R541.4
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本文编号：1501274