Background: Helicobacter pylor infection and nonsteroidal anti-inflammatory drugs (NSAIDs) are well-known major causes of peptic ulcers. This study aimed to characterize the features of bleeding peptic ulcers in Japan...Background: Helicobacter pylor infection and nonsteroidal anti-inflammatory drugs (NSAIDs) are well-known major causes of peptic ulcers. This study aimed to characterize the features of bleeding peptic ulcers in Japan. Methods: This prospective study evaluated 116 patients revealed to have bleeding peptic ulcers from January 2000 to December 2002. Results: Eighty-eight of the 116 patients (75.9% ) had H. pylori infection. Seventy (60.3% ) patients were positive for H. pylori with no history of NSAID use (group A), and 18 (15.5% ) were positive for H. pylori with a history of NSAID use (group B). Among the H. pylori-negative patients, 15 (12.9% ) were associated with NSAID use (group C). Thirteen (11.2% ) patients had no H. pylori infection or history of NSAID use (group D). Among the 33 patients with a history of NSAID use, 11 were on-demand NSAID users and 14 took daily low-dose aspirin. The patients in groups B and C were significantly older that those in groups A and D, and they more frequently had coexisting diseases compared with group A. In group D, 11 patients had atrophic changes revealed by endoscopic examination, suggesting a past H. pylori infection, and these atrophic changes remained at the time of bleeding. Many of the patients in group D had serious comorbidity. Compared with healthy control subjects, the concentrations of both phosphatidylcholine and phosphatidylethanolamine were significantly decreased in the antral gastric mucosa in all patient groups. Conclusions: NSAID use contributed to bleeding ulcers in 28.4% of patients; thus, low-dose aspirin or on-demand NSAID use may cause bleeding ulcers. There were only two (1.7% ) confirmed cases of H. pylori-negative, non-NSAID ulcers.展开更多
文摘Background: Helicobacter pylor infection and nonsteroidal anti-inflammatory drugs (NSAIDs) are well-known major causes of peptic ulcers. This study aimed to characterize the features of bleeding peptic ulcers in Japan. Methods: This prospective study evaluated 116 patients revealed to have bleeding peptic ulcers from January 2000 to December 2002. Results: Eighty-eight of the 116 patients (75.9% ) had H. pylori infection. Seventy (60.3% ) patients were positive for H. pylori with no history of NSAID use (group A), and 18 (15.5% ) were positive for H. pylori with a history of NSAID use (group B). Among the H. pylori-negative patients, 15 (12.9% ) were associated with NSAID use (group C). Thirteen (11.2% ) patients had no H. pylori infection or history of NSAID use (group D). Among the 33 patients with a history of NSAID use, 11 were on-demand NSAID users and 14 took daily low-dose aspirin. The patients in groups B and C were significantly older that those in groups A and D, and they more frequently had coexisting diseases compared with group A. In group D, 11 patients had atrophic changes revealed by endoscopic examination, suggesting a past H. pylori infection, and these atrophic changes remained at the time of bleeding. Many of the patients in group D had serious comorbidity. Compared with healthy control subjects, the concentrations of both phosphatidylcholine and phosphatidylethanolamine were significantly decreased in the antral gastric mucosa in all patient groups. Conclusions: NSAID use contributed to bleeding ulcers in 28.4% of patients; thus, low-dose aspirin or on-demand NSAID use may cause bleeding ulcers. There were only two (1.7% ) confirmed cases of H. pylori-negative, non-NSAID ulcers.
