阿司匹林致非静脉曲张性上消化道出血患者的预后分析

Prognostic Analysis of Aspirin-induced Non-varicose Upper Gastrointestinal Bleeding

目的探讨阿司匹林致非静脉曲张性上消化道出血患者的预后。方法选取2016年1月~2019年4月我院收治的非静脉曲张性上消化道出血患者197例,根据是否服用阿司匹林分为观察组(71例)和对照组(126例),比较两组临床特征(性别、年龄、既往心血管疾病史、既往恶性肿瘤病史)、内镜下表现(胃溃疡、十二指肠溃疡、复合型溃疡、食管炎、食管溃疡、糜烂性胃炎、贲门黏膜撕裂、消化道恶性肿瘤)及预后(住院时长、再出血、严重出血、院内死亡人数、出血相关死亡)。结果两组男性患者占比、既往恶性肿瘤病史占比比较,差异无统计学意义(P>0.05);阿司匹林组年龄大于非阿司匹林组,既往心血管疾病史占比高于非阿司匹林组,差异有统计学意义(P<0.05);阿司匹林组胃溃疡占比高于非阿司匹林组,十二指肠溃疡占比低于非阿司匹林组,差异有统计学意义(P<0.05);两组复合型溃疡、食管炎、食管溃疡、糜烂性胃炎、贲门黏膜撕裂、消化道恶性肿瘤占比比较,差异无统计学意义(P>0.05);阿司匹林组住院时长及院内死亡人数低于非阿司匹林组,差异有统计学意义(P<0.05);两组再出血、严重出血及出血相关死亡占比比较,差异无统计学意义(P>0.05)。结论服用阿司匹林发生上消化道出血患者的临床预后可能更好,另外阿司匹林可能不仅仅具有心血管保护作用,其潜在的作用仍有待临床进一步发现。

Objective To investigate the prognosis of patients with non-varicose upper gastrointestinal bleeding caused by aspirin.Methods A total of 197 patients with non-varicose upper gastrointestinal hemorrhage treated in our hospital from January 2016 to April 2019 were selected and divided into aspirin(71 cases)and non-aspirin group(126 cases)according to whether or not aspirin was taken.Compare the clinical characteristics of two groups(gender,age,history of previous cardiovascular disease,and history of previous malignant tumors),endoscopic findings(gastric ulcer,duodenal ulcer,compound ulcer,esophagitis,esophageal ulcer,erosive gastritis,cardia mucosa tear,and gastrointestinal malignancy)and prognosis(long hospital stay,rebleeding,severe bleeding,in-hospital deaths,and bleeding-related deaths).Results There was no significant difference in the proportion of male patients and the history of previous malignant tumors in the two groups(P>0.05).The aspirin group was older than the non-aspirin group,and the proportion of previous cardiovascular disease was higher than that of the non-aspirin group,the difference was statistically significant(P<0.05);the aspirin group had higher gastric ulcers than the non-aspirin group,and duodenal ulcers compared with the non-aspirin group,the difference was statistically significant(P<0.05);the proportion of composite ulcer,esophagitis,esophageal ulcer,erosive gastritis,cardia mucosa tear,gastrointestinal malignant tumor was compared in the two groups,the difference was not statistically significant(P>0.05);the length of hospital stay and the number of in-hospital deaths in the aspirin group were lower than those in the non-aspirin group,the difference was statistically significant(P<0.05).There was no significant difference in the proportion of rebleeding,severe bleeding,and bleeding-related deaths between the two groups(P>0.05).Conclusion The clinical prognosis of patients with upper gastrointestinal bleeding after taking aspirin is better;aspirin has more than just cardiovascular protection,Its potential role remains to be found in clinical practice.