氯化钾片相关性胃黏膜损伤的影响因素分析

doi:10.3969/j.issn.1671-7171.2025.11.015

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摘要 【目的】探讨氯化钾片相关性胃黏膜损伤的影响因素。【方法】选取2022年4月至2023年11月本院收治的88例接受氯化钾片治疗患者,采用胃黏膜损伤改良Lanza量表(MLS)评估患者是否发生胃黏膜损伤,根据是否发生胃黏膜损伤将患者分为发生组(n=34,1分≤MLS评分≤5分)和未发生组(MLS评分为0分,n=54)。比较两组的性别、年龄、体重指数(BMI)、吸烟、嗜酒、消化性溃疡史、心脑血管病史、幽门螺杆菌(Hp)感染情况、前列腺素E₂(PGE₂)、单核细胞趋化蛋白-1(MCP-1)、凝血活酶时间(APTT)、凝血酶原时间(PT)和凝血酶时间(TT),采用多因素Logistic回归分析氯化钾片相关性胃黏膜损伤的危险因素,采用受试者工作特征(ROC)曲线分析各指标预测氯化钾片相关性胃黏膜损伤的效能。【结果】两组性别、年龄、BMI、吸烟史、饮酒史、消化性溃疡史、心脑血管病史,以及血清PGE₂、MCP-1水平比较,差异无统计学意义(P>0.05);两组Hp感染所占比例、APTT、PT、TT比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,Hp感染及APTT、PT、TT延长是氯化钾片相关性胃黏膜损伤发生的独立危险因素(P<0.05)。Spearman相关性分析显示,溃疡直径、溃疡底部厚苔面积、周围黏膜充血面积、溃疡数目与MLS评分均呈正相关(r_s=0.477、0.435、0.492、0.399,均P<0.05)。Hp感染情况及APTT、PT、TT联合预测氯化钾片相关性胃黏膜损伤的灵敏度(85.29%)、特异度(83.33%)、准确率(82.95%)、Kappa值(0.664)均高于单一指标(P<0.05)。【结论】临床医师可根据Hp感染情况及凝血功能指标综合评估患者发生氯化钾片相关性胃黏膜损伤的风险,以更准确地识别高危患者,从而提前采取预防措施。

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	汪彦彦
	李英宵
	朱珍珍

关键词 ：胃疾病, 胃黏膜, 氯化钾, 影响因素分析

Abstract：【Objective】To explore the influencing factors for potassium chloride tablet-associated gastric mucosal injury. 【Methods】A total of 88 patients who received potassium chloride tablet treatment in our hospital from April 2022 to November 2023 were selected. The Modified Lanza Scale (MLS) for gastric mucosal injury was used to assess whether gastric mucosal injury occurred. According to the presence of gastric mucosal injury, the patients were divided into the occurrence group (n=34, MLS score 1–5) and the non-occurrence group (n=54, MLS score 0). Gender, age, body mass index (BMI), smoking, alcohol consumption, history of peptic ulcer, history of cardiovascular and cerebrovascular diseases, Helicobacter pylori (Hp) infection, levels of prostaglandin E₂ (PGE₂) and monocyte chemoattractant protein-1 (MCP-1), activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) were compared between the two groups. Multivariate Logistic regression analysis was used to identify the risk factors for potassium chloride tablet-associated gastric mucosal injury, and receiver operating characteristic (ROC) curve was used to analyze the efficacy of each index in predicting this injury. 【Results】There were no statistically significant differences between the two groups in gender, age, BMI, smoking history, alcohol consumption history, history of peptic ulcer, history of cardiovascular and cerebrovascular diseases, or serum levels of PGE₂ and MCP-1 (P>0.05); significant differences were found in the proportion of Hp infection, APTT, PT, and TT between the two groups (P<0.05). Multivariate Logistic regression analysis showed that Hp infection and prolonged APTT, PT, and TT were independent risk factors for potassium chloride tablet-associated gastric mucosal injury (P<0.05). Spearman correlation analysis revealed that ulcer diameter, area of thick coating at the ulcer base, area of surrounding mucosal congestion, and number of ulcers were positively correlated with MLS score (r_s=0.477, 0.435, 0.492, 0.399; mean P<0.05). The sensitivity (85.29%), specificity (83.33%), accuracy (82.95%), and Kappa value (0.664) of the combined prediction using Hp infection status, APTT, PT, and TT for potassium chloride tablet-associated gastric mucosal injury were higher than those of single indexes (P<0.05).【Conclusion】Clinicians can comprehensively assess the risk of potassium chloride tablet-associated gastric mucosal injury in patients based on Hp infection status and coagulation function indexes. This helps to more accurately identify high-risk patients and take preventive measures in advance.

Key words： Stomach Diseases Gastric Mucosa Potassium Chloride Root Cause Analysis

收稿日期: 2024-06-25

中图分类号:

R573

引用本文:

汪彦彦, 李英宵, 朱珍珍. 氯化钾片相关性胃黏膜损伤的影响因素分析[J]. 医学临床研究, 2025, 42(11): 1895-1898.
WANG Yanyan, LI Yingxiao, ZHU Zhenzhen. Analysis of Influencing Factors for Potassium Chloride Tablet-Associated Gastric Mucosal Injury. JOURNAL OF CLINICAL RESEARCH, 2025, 42(11): 1895-1898.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.11.015 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I11/1895

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