根除幽门螺杆菌预防长期服用小剂量阿司匹林患者上消化道黏膜损伤的临床研究

Clinical Study on Helicobacter Pylori Eradication Therapy in Prevention of Upper Digestive Tract Mucomembranous Injury in Patients Using Long-term Low Dose Aspirin

目的研究根除幽门螺杆菌(HP)治疗对于长期服用小剂量阿司匹林患者预防上消化道黏膜损伤的作用。方法选择2015年6月—9月收治的165例合并HP感染的长期服用小剂量阿司匹林患者,按治疗方法分为观察组和对照组。其中观察组83例,进行抗HP治疗,对照组82例常规治疗,随访期为1年。随访期间每月对两组患者行大便潜血检查,每6个月行胃镜检查,明确是否出现上消化道黏膜损伤,并行^(13)C-尿素呼气试验追踪HP感染情况。结果随访6和12个月后,观察组上消化道黏膜总损伤率均低于对照组(P<0.05)。服用阿司匹林6个月后,观察组上消化道症状总发生率明显低于对照组(P<0.05)。观察组停药1个月后复查HP感染转阴78例,根治率93.98%。结论对于HP感染的长期服用小剂量阿司匹林患者行根除HP治疗可以降低上消化道黏膜损伤的风险。

Objective To investigate effect of helicobacter pylori （HP） eradication therapy in prevention of upper digestive tract mucomembranous injury in patients using long-time low dose Aspirin. Methods A total of 165 pa- tients complicated with HP infection from June to September 2015 using long-term low dose Aspirin were divided into ob- servation group （ n = 83） and control group （ n = 82） according to treatment methods. Observation group received anti-HP treatment, while control group was given routine treatment, and the follow-up period was 1 year. During the follow-up, fecal occult blood tests were performed monthly, and gastroscopy tests were performed every 6 months for confirming whether or not there was upper digestive tract mucomembranous injury for all patients, and carbon 13-urea breath test was performed for learning condition of HP infection. Results In follow-up for 6 and 12 months, the total injury rates of up- per digestive tract mucosa in observation group were significantly lower than those in control group （ P 〈 0.05 ）. After tak- ing Aspirin for 6 months, the total incidence rate of upper gastrointestinal symptoms in observation group was significantly lower than that in control group （P 〈 0.05）. There were 78 patients with negative HP infection with 93.98% eradication rate by rechecking 1 month after drug withdrawal in observation group. Conclusion HP eradication therapy can decrease risk of upper digestive tract mucomembranous injury for HP infection patients using long-time low dose Aspirin.