肠溶阿司匹林引起上消化道出血的危险因素分析

Analysis of the risk factors of intestinal tract bleeding caused by enteric- coated aspirin

目的探讨肠溶阿司匹林引起上消化道出血的临床特点。方法选择2012年1月-2014年1月我院门诊或住院服用肠溶阿司匹林的患者565例，比较不同服药时间、服药剂量及是否加用胃黏膜保护剂、质子泵抑制剂（PPI）、H2受体拮抗剂对上消化道出血发生率的影响。结果随着肠溶阿司匹林服用时间延长、服药剂量加大，上消化道出血发生率增加（P〈0．05）；联用胃黏膜保护剂、PPI或H2受体拮抗剂可以减少上消化道出血发生率（P〈0．05），PPI组和H2受体拮抗剂组效果优于胃黏膜保护剂组（P〈0．05）。结论建议小剂量服用肠溶阿司匹林，需要长期服用的患者建议联合应用PPI或H2受体拮抗剂。

Objective To discuss the clinical characteristics of upper gastrointestinal hemorrhage caused by enteric - coated aspirin. Methods A total of 565 patients admitted into our hospital from January 2012 to January 2014 were included into the current study, who took enteric - coated aspirin. The effects of different administration time and doses, the combined use of gastric mucosal protective agents, proton pump inhibitors （PPI） and H2 receptor antagonists on the rate of upper gastrointestinal hemorrhage were compared. Results As the use of enteric - coated aspirin extended and the doses increased, a higher incidence of upper gastrointestinal hemorrhage was seen （ P 〈 0.05 ）. The combined use of gastric mucosal protective agents, PPI or H2 receptor antagonists could significantly decrease the bleeding rate （P 〈 0.05 ）. The therapeutic efficacy of PPI and H2 receptor antagonists were better than that of gastric mueosal protective a- gents （P 〈 0.05）. Condusion A small dose of enteric - coated aspirin is recommended. A combined use of PPI or H2 receptor antagonists is required for long - term usage.