不同阿司匹林肠溶片对老年人上消化道黏膜影响的比较

Comparison of effects of different enteric-coated aspirin tablets on upper gastrointestinal tract in the elderly

目的观察不同阿司匹林肠溶片对老年人上消化道黏膜的影响。方法将我院近3年服用阿司匹林肠溶片（100mg，1次／d）≥3个月、年龄〉65岁的老年患者404例，按服用药物不同分为拜阿司匹灵组232例和普通阿司匹林肠溶片组172例，对两组患者的临床资料和胃镜检查结果进行比较，通过X^2检验，比较两种不同阿司匹林肠溶片对老年人上消化道影响的差异。结果拜阿司匹灵组上消化道出血47例（20．3％），普通阿司匹林肠溶片组55例（32．0％），差异有统计学意义（X^2=7．19，P〈0．01）；拜阿司匹灵组胃镜检查显示胃、十二指肠炎症16例（6．9％），消化性溃疡8例（3．5％）；普通阿司匹林肠溶片组分别为12例（7．0％）和36例（20．9％），检出消化性溃疡差异有统计学意义（X^2=31．10，P〈0．01）；胃肠道不良反应发生率拜阿司匹灵组20例（8．6％），普通阿司匹林肠溶片组40例（23．3％），差异有统计学意义（X^2=16．73，P〈0．01）。结论拜阿司匹灵对老年人上消化道的影响明显小于普通阿司匹林肠溶片，在临床上使用拜阿司匹灵比普通阿司匹林肠溶片更安全。

Objective To study the effects of different enteric coated aspirin tablets on upper gastrointestinal tract in the elderly. Methods 404 inpatients aged more than 65 years in last three years who took enteric coated aspirin tablets （100mg/d） for more than three months were analyzed. They were divided into two groups： bayaspirin treated group （232 cases） and control group with ordinary enteric-coated aspirin tablet treatment （172 cases）. The clinical data and the results of gastroscopy were compared between two groups, and the effects of two kinds of enteric-coated aspirin tablets on upper gastrointestinal tract in the elderly were analyzed by Chi-square test. Results The upper gastrointestinal bleeding rates were 20.3% in Bayaspirin-treated group （47/232） and 32.0% in control group （55/172）, and there was significant difference between two groups（X^2=7.19 ,P〈0.01） . Gastroscopy indicated that gastroduodenal inflammation occurred in 16 patients （6.9%） and peptic ulcer occurred in 8 patients （3.5 %） in bayaspirin-treated group, while gastroduodenal inflammation occurred in 12 patients （7.0 %） and peptic ulcer occurred in 36 patients（20.9%）in control group. The difference of the incidence of peptic ulcer between two groups had statistical signifieance（x^2 =31.10, P〈0.01）. The incidences of gastrointestinal adverse reactions were 8.6% （20/232） in bayaspirintreated group and 23.3% （40/172） in control group, and there was a statistical difference between two groups. Conclusions Compared with ordinary enteric coated aspirin tablet, bayaspirin has less adverse effects on upper gastrointestinal tract in the elderly and is more safe for treatment.