非甾体抗炎药相关性胃十二指肠溃疡并出血的临床特点及幽门螺杆菌对溃疡特点的影响

Clinical characteristics of non-steroidal anti-inflammatory drugs associated gastroduodenal ulcer bleeding and the effect of Helicobacter pylori

目的 研究非甾体抗炎药 (NSAIDs)所致胃十二指肠溃疡并出血的临床特点及幽门螺杆菌对溃疡特点的影响。方法 调查我院 1997年 1月至 2 0 0 1年 12月间因胃十二指肠球部溃疡并出血收住院治疗患者的临床资料 ,根据入院前 1周内有无服用NSAIDs史将患者分为两组 ,对两组患者的临床资料进行分析比较。结果 服药组 86例 ,未服药组 36 0例。服药组患者的年龄更高 ,血红蛋白下降更明显 (P =0 .0 0 4 ) ,胃溃疡和复合溃疡、多发溃疡及大溃疡在服药组更多见 (P <0 .0 0 1)。未服药组幽门螺杆菌 (Hp)的感染率为72 .5 % ,服药组为 5 3.4 % (P =0 .0 0 1)。进一步的研究发现 ,Hp感染状态对NSAIDs相关溃疡并出血的临床特点无明显影响 ,但胃黏膜糜烂更常见 (P <0 .0 5 )。结论 应加强对NSAIDs相关性胃十二指肠溃疡并出血临床特点的认识 。

Objective To study the clinical characteristics of non steroidal anti inflammatory drugs(NSAIDs) associated gastroduodenal ulcer bleeding and the effect of Helicobacter pylori.Methods The patients with gastroduodenal bleeding who were in hospitalization of our ward from Jan,1997 to Dec,2001 were divided into two groups according to whether consumed NSAIDs or not within one week previous to the onset of bleeding.Results 446 patients were investigated,86 in NSAIDs group,360 in non NSAIDs group.The patients in NSAIDs were older than those in non NSAIDs.Hemoglobin was lower in NSAIDs(P= 0.004 ).There was more gastric ulcer and complex ulcer in the NSAIDs group than in non NSAIDs group (P< 0.001 ).NSAIDs user had more number of ulcers (P< 0.001 ).Helicobacter pylori was present in 72.5% of non NSAIDs group and 53.4% of NSAIDs group (P= 0.001 ).In further study,it was found that Helicobacter pylori state didn't affect the clinical characteristics of NSAIDs'ulcer bleeding and there was more erosion in Hp(+) NSAIDs patients.Conclutions The clinical characteristics of NSAIDs associated gastroduodenal bleeding should be better understood to decrease NSAIDs' ulcer and their complication.