老年患者上消化道出血与服用小剂量阿司匹林的关系探讨

Relationship between upper digestive tract bleeding in elderly patients and long term administration of low-dose aspirin

目的探讨长期服用小剂量阿司匹林的老年患者上消化道出血的发生情况。方法收集281例长期服用小剂量阿司匹林的老年患者,74例在服药过程中发生上消化道出血者为出血组,其余无出血的207例为非出血组,行胃镜检查了解胃、十二指肠损伤情况并进行幽门螺杆菌(Hp)的检测,分析其上消化道出血的影响因素。结果上消化道出血的发生率为26%(74/281),出血组在年龄>65岁、既往出血病史、Hp感染中的比率显著高于非出血组(P<0.01)。结论长期小剂量服用阿司匹林可增加老年患者上消化道出血的危险性,Hp感染、过去出血史、年龄是主要的影响因素。

Objective To investigate the relationship between the upper digestive tract bleeding in elderly patients and long term administration of low-dose aspirin. Methods The clinical data of 281 elderly patients who administrated with low-dose aspirin for a long time were collected, including 74 patients with digestive tract bleeding （the bleeding group） and 207 patients without digestive tract bleeding （the non-bleeding group）. Endoscopic examination were performed to identify the mucosal injuries and Helieobacter pylori infection were tested. Results The incidence of upper digestive tract bleeding was 26% （74/281）. In the bleeding group, patients were more likely to be older than 65 years old, had a bleeding history and with Helicobacter pylori infection （P〈0.01）. Conclusion Long term use of low-dose aspirin in elderly patients increase the danger to develop upper digestive tract bleeding, and age older than 65 years old, a bleeding history and Helicobacter pylori infection are predominant risk factors.