非类固醇抗炎药与消化道穿孔  

Relevance of use of NSAID and gastrointestinal perforation

作　　者：霍惠峰 葛军[2] 杨伟刚[2] 李智[3] 

机构地区：[1]上海海员医院消化科,200080 [2]上海市市东医院消化科 [3]复旦大学附属华山医院内分泌科

出　　处：《上海医学》2004年第6期406-408,共3页Shanghai Medical Journal

摘　　要：目的　探讨消化道穿孔与非类固醇抗炎药 (NSAIDs)服药史的关系及其他危险因素。方法　选取在 3所医院就诊并明确诊断的消化道穿孔患者 76例作为穿孔组 ,选取同时期的 15 2例非消化道穿孔患者作为对照组 ,进行分析。结果　穿孔组中 ,79%为上消化道穿孔 ,2 1%为下消化道穿孔 ;71%的患者在发病前有NSAIDs服药史 ;而对照组仅为 2 7% (P <0 .0 1)。Logstic回归分析显示吸烟、饮酒、关节炎和服用NSAIDs是消化道穿孔的 4个独立的危险因素 ,而幽门螺杆菌 (Hp)阳性与消化道穿孔的发生不相关。穿孔患者的病死率与其年龄相关 ,与NSAIDs服用量不相关。结论　NSAID是上、下消化道穿孔的危险因素 ,吸烟和饮酒可使危险性进一步增加。Objective To appraise the relevance of use of NSAID in gastrointestinal perforation. Methods 76 patients with gastrointestinal perforation and 152 matched controls were analyzed for a comparison of risk factors. Results Of the 76 cases, 79% were upper and 21% were lower gastrointestinal perforations.A history of NSAID administration was found in 71% of the cases (70% upper, 75% lower) vs 26.9% of the controls (odds ratio:6.64; 95% confidence interval: 3.6～12.2;P<0.01).Other lndependent risk factors were smoking, alcohol drinking, and a history of arthritis or peptic ulcer but not the positive HeIicobacter pylori serology.The mortality rate was related to the age of the patient rather than the dosage of NSAID.Conclusion Use of NSAID is associated with occurrence of upper or lower gastrointestinal perforation while smoking and alcohol consumption can further increase the risk.

关 键 词：非类固醇抗炎药 消化道穿孔 幽门螺杆菌 治疗 消化性溃疡 

分 类 号：R656.6[医药卫生—外科学]