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中度至重度的慢性肾脏病患者中有30～70%死于上消化道出血;十二指肠溃疡曾被认为是主要的出血原因。慢性肾衰患者中均可见到血清胃泌素及胃酸分泌、胃粘膜屏障及血凝功能的紊乱,这些被认为是引起上消化道出血的重要因素;但服用致溃疡药物、吸烟、饮酒以及机体应激状态等却极少引起注意。作者对20例有上消化道出血的中及重度慢性肾脏病和40例上消化道出血而无肾脏病的患者进行了比较。结果表明,肾脏病组除肾功能损害外,唯一的特点为重度饮酒者所占比例显著低于无肾衰组。两组的出血部位无明显差别。肾脏病组中出血由十二指肠溃疡引起者占20%,低于无肾脏病组(30%);而胃部病变(即胃溃
30-70% of patients with moderate to severe chronic kidney disease die from upper gastrointestinal bleeding; duodenal ulcers have been considered the leading cause of bleeding. Serum gastrin and gastric acid secretion, gastric mucosal barrier and hemagglutination disorders can be seen in patients with chronic renal failure, which is considered to be an important factor causing upper gastrointestinal bleeding; but taking ulcer drugs, smoking, drinking and the body Stress, but rarely pay attention. The authors compared 20 patients with moderate and severe chronic kidney disease with upper gastrointestinal bleeding and 40 with upper gastrointestinal bleeding without kidney disease. The results showed that, in addition to kidney function impairment in renal disease group, the only characteristic of heavy drinkers was significantly lower than the proportion of no renal failure group. Bleeding site no significant difference between the two groups. Kidney disease group bleeding caused by duodenal ulcer accounted for 20%, lower than no kidney disease group (30%); and stomach lesions (ie, gastric ulcer