非甾体抗炎药相关性溃疡并出血的临床特点

Clinical characteristics of non-steroidal anti-inflammatory drugs associated gastroduodenal ulcer bleeding

目的 研究非甾体抗炎药 (NSAIDs)相关性胃十二指肠溃疡并出血的临床特点。方法 调查我院 1 997年 1月～ 2 0 0 1年 1 2月间因胃十二指肠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 2组 ,对 2组病人的临床资料进行分析比较。结果 本研究共纳入 446例患者 ,其中服药组 86例 ,未服药组 360例。 2组病人在性别、出血方式、既往消化性溃疡史、胃及十二指肠溃疡的具体部位、糜烂 ,以及是否需要内镜治疗等方面的差异无显著性。但是服药组患者的年龄较未服药组更高 ,血红蛋白在服药组下降更明显 (P =0 0 0 4 ) ;胃溃疡和复合溃疡、多发溃疡在服药组更多见 (P <0 0 0 1 ) ,而未服药组幽门螺杆菌 (Hp)的感染率较服药组更高 ,分别为 72 5 %和 53 4% (P =0 0 0 1 )。进一步的研究发现 ,患者年龄和Hp感染状态对NSAIDs相关溃疡并出血的临床特点无明显影响。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 ,尽量减少NSAIDs的不良反应。

Objective To study the clinical characteristics of non steroidal anti inflammatory drugs (NSAIDs) associated gastroduodenal ulcer bleeding Methods Patients who were hospitalized in our ward because of gastroduodenal bleeding from Jan, 1997 to Dec, 2001 were divided into two groups according to consumption of NSAIDs or not in the week previous to the onset of bleeding Results 446 patients were investigated with 86 in NSAIDs group and 360 in non NSAIDs group There was no significant difference in sex, way of bleeding, history of peptic ulcer, bleeding site in stomach or duodenum, presence of erosion and the need of endoscopic injection therapy or not between the two groups However, the patients in NSAIDs group were older than those in non NSAIDs group Hemoglobin level was lower in NSAIDs group ( P =0 004) There was more gastric ulcer and complex ulcer in the NSAIDs group than in non NSAIDs group ( P <0 001) NSAIDs users had more ulcers ( P <0 001) Helicobacter pylori (Hp)was present in 72 5% of the non NSAIDs group and 53 4% of the NSAIDs group ( P =0 001) In an another study, we found that age of the patients or Hp state didn't affect the clinical characteristics of NSAIDs ulcer bleeding Conclusions The clinical characteristics of NSAIDs associated gastroduodenal bleeding should be better understood so as to decrease the occurrence of NSAIDs ulcer and its complication