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目的通过测定急诊重症患者胃泌素(GAS)水平,探讨应激性溃疡的发生和胃泌素、A-PACHEⅡ评分等之间的关系,从而发现应激性溃疡的早期指标。方法对急诊ICU顺序住院的资料完整的80例重症患者进行回顾性研究。所有患者入院后于次日晨测定血清胃泌素;同时对患者进行A-PACHEⅡ评分。分A组共45例为应激性溃疡组,B组35例为无应激性溃疡组;观察应激性溃疡情况,在应激溃疡发生后第3、7天重新检测GAS和进行APACHEⅡ评分,观察应激溃疡消失后GAS水平。结果A、B组患者GAS比较差异有统计学意义(P<0.05);A、B组患者APACHE II评分比较(P<0.05)差异有统计学意义。结论 GAS水平的高低在一定程度上反映了机体的应激状态;GAS的水平可能成为应激溃疡发生的检测指标,从而指导临床对应激性溃疡的预测和提前预防提供参考。
Objective To determine the early indicators of stress ulcer by measuring the level of gastrin (GAS) in emergency critics and discussing the relationship between the occurrence of stress ulcer and gastrin, A-PACHEⅡscore and so on. Methods A retrospective study was conducted on 80 intensive cases with complete data of hospitalized emergency ICU. Serum gastrin was measured in all patients on the following morning after hospital admission. A-PACHE II was also performed on patients. 45 cases in group A were stress ulcer group and 35 cases in group B were stress ulcer group. To observe stress ulcer, GAS and APACHE II score were re-tested on day 3 and 7 after stress ulcer , Observe the disappearance of stress ulcer GAS level. Results There was significant difference in GAS between groups A and B (P <0.05). There was significant difference in APACHE II scores between groups A and B (P <0.05). Conclusion The level of GAS reflects the stress state of the body to a certain extent. The level of GAS may be the detection index of stress ulcer, which can guide the clinical prediction and prevention of stress ulcer.