小剂量阿司匹林与老年人胃十二指肠粘膜病变的关系

Low-dose aspirin and gastric and duodenal mucosal damage in the elderly

目的：观察分析小剂量阿司匹林（ａｓｐｉｒｉｎ， ＡＳＡ，每天≤１００ ｍ ｇ） 对老年人胃、十二指肠粘膜的损伤。方法：ＡＳＡ组４１ 例，未服药对照组９６ 例，对照分析两组老年人胃、十二指肠粘膜病变胃镜检出率。结果：ＡＳＡ组胃粘膜病变的检出率（５８．５％ ） 高于对照组（３５．４％ ） 有显著性差异（Ｐ＝ ０．０１２），两组间十二指肠粘膜病变检出率（分别为４．９％ 和５．２％ ） 无显著性差异（Ｐ＝ ０．９３６）；进一步分析显示ＡＳＡ组和对照组浅表粘膜病变（糜烂和出血性胃炎）检出率为５１．２％ 和３２．３％ ，有显著性差异（Ｐ＝ ０．０３７），两组间溃疡检出率（分别为９．８％ 和９．４％ ）无显著性差异（Ｐ＝ ０．９９４）。结论：服用小剂量ＡＳＡ对老年人胃粘膜有损伤作用，主要引起浅表粘膜病变（糜烂和出血性胃炎）。

Objective:To confirm the damage of gastric and duodenal mucosa associated with low dose aspirin (ASA, ≤100 mg Daily) in the elderly. Methods:Case control study was performed between 41 elderly patients taking with low dose ASA and 97 cases without doing. The damage lesions of gastric and duodenal mucosa were investigated by endoscopy and biopsy. Results:The rate of the gastric mucosal lesion in ASA group (58.5%) was significantly higher than that in control group (35.4%, P =0 012). However, the rate of duodenal mucosal lesion in ASA group was similar to the control group (4.9% VS 5.2%, P =0 936). The rate of superficial mucosal damage (erosion and bleeding gastritis) in ASA group (51.2%) was significantly higher than control group (32.3%, P =0 037). The difference of gastric and duodenal ulcer between two groups (9.8% and 9.4% respectively) was not significant ( P =0 994). Conclusion: Low dose ASA may damage gastric mucosa and cause gastric superficial mucosal lesions in the elderly.