老年人上消化道出血与长期服用小剂量阿司匹林的关系

The relationship between upper gastrointestinal bleeding and long-term low dose aspirin intake in the elderly

目的 观察长期服用小剂量阿司匹林老年人上消化道出血的发生情况及影响因素。方法 5 6例服用小剂量阿司匹林老年人 ,根据胃镜检查前一周内有无上消化道出血将其分为出血组与非出血组 ,胃镜观察其胃、十二指肠黏膜损伤情况 ,快速尿素酶试验和改良Giesma染色方法检测幽门螺杆菌 ,分析其上消化道出血的有关影响因素。结果 5 6例老年人中发生上消化道出血 17例 ,发生率 30 4 % ,出血组胃黏膜损伤积分、幽门螺杆菌 (Hp)感染率均明显高于非出血组 (P <0 0 1)。多因素分析表明 ,Hp感染、既往出血病史及年龄可增加上消化道出血的危险性 ,而用药时间与上消化道出血无相关性。结论 长期小剂量服用阿司匹林可增加老年人上消化道出血的危险性 ,其发生与Hp感染。

Objective To observe the incidence and factors of the occurrence in the upper gastrointestinal bleeding(UGIB)in elderly taking low dose aspirin for long term.Methods 56 elderly taking low dose aspirin were divided into groups according to whether had UGIB within one week before endoscope.The endoscopic mucosal injury scores was used for assessment of gastric and duodenal mucosal injury.Helicobacter pylori(Hp)infection was bassed on the rapid ureas testing and modifying Giemsa stain.The factors of the occurrence of UGIB was analysed.Results 17 elderly presented with UGIB in 56 elderly taking low dose aspirin.The incidence was 30.4%.The endoscopic mucosal injury scores and Hp infection rate were significant increased in groups with UGIB than in no-UGIB group(P<0.01).Multivariate analyse showed that Hp infection,a history of UGIB and ages was associated with higher risk of UGIB.But there is no relationship between times of aspirin intaking and UGIB.Conclusion The elderly taking long-term,low dose aspirin increase the risk of UGIB.The occurrence of UGIB is associated with Hp infection,a history of UGIB and ages.