长期小剂量阿司匹林对冠心病患者上消化道损伤的临床预后分析

Analysis of Clinical Prognosis of Upper Digestive Tract Injury of Patients with Long-time Use of Low-dose Aspirin and Coronary Heart Disease

目的分析长期小剂量服用阿司匹林对冠心病患者上消化道损伤的临床预后效果。方法选取从2014年1月~2015年12月本院收治的长期服用小剂量阿司匹林伴有冠状动脉粥样硬化性心脏病、且曾有上消化道出血的患者53例作为研究组,另选同期长期服用小剂量阿司匹林但未伴有冠状动脉粥样硬化性心脏病,曾出现上消化道出血症状的患者52例为对照组,检测胃黏膜的评分和血清学相关指标,评价患者的预后状况,并进行对比分析。结果两组胃黏膜评分为0、1、2分的例数比较,差异无统计学意义(P>0.05);两组胃黏膜评分为3分的例数比较,差异有统计学意义(P<0.05);两组血清学指标PGⅠ、PGⅡ和G-17分别比较,差异有统计学意义(P<0.05);研究组初始止血成功34例,和对照组(37例)比较,差异无统计学意义(P>0.05);研究组1周内止血失败、1周后再出血例数分别为9例、5例,明显多于对照组(分别为2例、0例),差异有统计学意义(P<0.05)。结论长期小剂量服用阿司匹林的冠心病患者的上消化道损伤的临床预后情况复杂,出血时间更长,止血更难,恢复效果较差。

Objective To analyze clinical prognosis of upper digestive tract injury of patients with long-time use of low-dose aspirin and coronary heart disease. Methods 53 patients with upper digestive tract hemorrhage complicated with coronary heart disease who took low-dose aspirin for a long time and admitted to our hospital from January 2014 to December 2015 were selected as the research group.52 patients with upper digestive tract hemorrhage complicated with no coronary heart disease who took low-dose aspirin for a long time and admitted to our hospital at the same time were selected as the control group.Gastric mucosa score and serology related index were tested.ln addition,prognosis of patients was evaluated and comparatively analyzed. Results Cases with gastric mucosa score of 0,1 and 2 in two groups had no significant difference,P 〉 0.05. Cases with gastric mucosa score of 3 in two groups had significant difference,P 〈 0.05.Serology indexes such as PG Ⅰ ,PG Ⅱ and G-17 of two groups were respectively compared.The difference was significant,P 〈 0.05.In the research group,there were 34 cases with initial and successful hemostasis. In the control group,there were 37 cases with initial and successful hemostasis. The difference was no statistical significant （P 〉 0.05）.In the research group,there were 9 cases with hemostasis failure within 1 week and 5 cases with recurrent hemorrhage after 1 week,significantly than those of the control group （2 cases,0 cases respectively）,P 〈 0.05. Conclusion Clinical prognosis of upper digestive tract injury of patients with coronary heart disease and long-time use of low-dose aspirin is complicated.h has longer time of hemorrhage,more difficuhies in hemostasis and worse recovery effect.