本文關(guān)鍵詞： 冠心病 胃食管反流病 危險因素 關(guān)聯(lián)性　出處：《大連醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討胃食管反流病(GERD)與冠心病的臨床關(guān)聯(lián)性并分析其危險因素,為臨床診治提供理論依據(jù)。方法:對2016年1月～2016年12月于遼寧省人民醫(yī)院消化內(nèi)科就診的393例患者的病例進行回顧性分析。首先收集167例曾行冠狀動脈造影確診為冠心病目前于我院消化科住院的患者作為觀察組(冠心病組),再收集同期于本科門診及住院就診的226例非冠心病患者作為對照組(非冠心病組),運用EpiData3.0錄入所得資料,采用SPSS21.0軟件對收集的資料進行統(tǒng)計分析,計數(shù)資料應用構(gòu)成比、率、均數(shù)和標準差進行描述性分析,分類變量采用卡方檢驗進行統(tǒng)計推斷分析。比較兩組之間性別、年齡等一般情況,比較兩組之間胃食管反流病的發(fā)生率情況,比較兩組之間GERD患者非糜爛性反流病(NERD)、反流性食管炎(A、B級)、反流性食管炎(C、D級)、Barrett食管之間的差異;進而探討冠心病與胃食管反流病的臨床相關(guān)性,并進一步對比分析觀察組(冠心病組)中合并GERD及未合并GERD兩組之間在性別、年齡、BMI、阿司匹林服用史、硝酸酯類藥物服用史、高血壓、糖尿病等相關(guān)指標的區(qū)別,從而探討冠心病與胃食管反流病的臨床相關(guān)性,并分析冠心病患者并發(fā)胃食管反流病的危險因素。結(jié)果:1.一般情況:觀察組患者年齡介于44-88歲之間,平均年齡(65.77±10.59)歲,對照組年齡介于34-87歲之間,平均年齡(63.74±11.06)歲,兩組比較無差異(P0.05)。兩組患者性別構(gòu)成:觀察組男性93例,女性74例;對照組男性117例,女性109例;兩組比較性別構(gòu)成無差異(P= 0.4410.05)。2.冠心病組合并胃食管反流病患者70例,占總數(shù)(167)的41.92%,非冠心病組胃食管反流病患者45例,占總數(shù)(226)的19.91%,冠心病患者GERD發(fā)病率(41.92%)高于非冠心病組GERD發(fā)病率(19.91%),差異具有統(tǒng)計學意義(P0.05)。3.冠心病組胃食管反流病患者中非糜爛性食管炎占42.9%,反流性食管炎A、B級占30.0%,C、D級占14.3%,Barret食管占12.9%;非冠心病組胃食管反流病患者中非糜爛性食管炎占42.2%,反流性食管炎A、B級占37.8%,C、D級占11.1%,Barret食管占8.9%,兩組比較無統(tǒng)計學意義(P0.05)。4.對納入研究指標進行單因素分析顯示阿司匹林服用史、硝酸酯類藥物服用史以及高脂血癥有統(tǒng)計學意義,對有統(tǒng)計學意義的指標進行Logistic回歸分析,得出高脂血癥為獨立危險因素。結(jié)論:1.胃食管反流病與冠心病之間存在關(guān)聯(lián)性:冠心病患者胃食管反流病發(fā)生率高于非冠心病患者;2.冠心病并GERD患者與非冠心病并GERD患者比較:兩組中非糜爛性反流病,反流性食管炎(A、B級),反流性食管炎(C、D級),Barrett食管構(gòu)成無差異。3.阿司匹林服用史、硝酸酯類藥物服用史、高脂血癥可能為冠心病合并胃食管反流病的危險因素,其中高脂血癥為冠心病合并胃食管反流病的獨立危險因素。
[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 鹵10.59 years, while those in the control group were between 34 and 87 years old, with an average age of 63.74 鹵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.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R571;R541.4
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本文編號：1501274