长期服用小剂量肠溶型阿司匹林对胃十二指肠黏膜损害的病例对照研究  

Effects of Long-term, Low-dose, Enteric-coated Aspirin on Gastroduodenal Mucosa: A Case-control Study

作　　者：张大真[1] 权正良[1] 李增烈[2] 

机构地区：[1]西安交通大学医院内科,710049 [2]陕西省人民医院消化内科

出　　处：《胃肠病学》2006年第7期427-430,共4页Chinese Journal of Gastroenterology

摘　　要：背景:长期以来,因预防或治疗需要而长期服用小剂量肠溶型阿司匹林的安全性一直受到关注。目的:观察长期服用小剂量(≤100mg/d)肠溶型阿司匹林对胃十二指肠黏膜的损害情况。方法:纳入5年中服用小剂量肠溶型阿司匹林超过3个月且既往无消化性溃疡和消化道出血史、胃镜检查前2周未服用其他非甾体抗炎药(NSAID)、抑酸剂、抗生素、铋剂等药物、未接受过幽门螺杆菌(H.pylori)根除治疗而具有上消化道症状者行内镜检查。结果:92例入选患者中,40例(43.5%)发现轻度胃十二指肠黏膜损害,但无一例形成黏膜溃疡。黏膜损害组和无黏膜损害组患者的年龄、性别、吸烟、阿司匹林日平均用量和常见消化不良症状均无显著差异(P>0.05)。黏膜损害组的H.pylori感染率显著高于无黏膜损害组(P<0.05)。尽管吸烟、年龄的分层分析未能证实H.pylori感染在黏膜损害中的重要作用,但H.pylori的感染程度与黏膜损害程度呈正相关(rs=0.308,P<0.05)。结论:长期服用小剂量肠溶型阿司匹林可引起轻度胃十二指肠黏膜损害,H.pylori感染、吸烟和年龄均是危险因素,但H.pylori感染的危险性可能更大。Background： The safety of long-term, low-dose, enteric-coated aspirin for the purpose of prevention or treatment of certain illness has attentively focused upon. Aims： To determine whether gastroduodenal mucosa could be injured by longterm, daily administration of low-dose （≤100 mg/d）, enteric-coated aspirin. Methods： A total of ninety-two patients with dyspeptic symptoms, taking low dose, enteric-coated aspirin daily for over three months, without history of peptic ulcer and alimentary tract hemorrhage, without taking other non-steroidal anti-inflammatory drug （NSAID）, antacid, antibiotic and bismuth, and without Helicobacterpylori （H. pylori） eradication were endoscopied. Results： Of all patients, 40 （43.5%） had mild mucosal injury at endoscopy, but no ulcers were observed. There were no differences in age, sex, smoking, mean dose of aspirin, and common dyspeptic symptoms between the mucosal injury and non-mucosal injury groups （P〉0.05）; H. pylori infection was more frequent in the mucosal injury group than that in the non-mucosal injury group （P〈0.05）, but in smoking and age stratified analysis, the role of H. pylori had not been confirmed. However, a significant correlation was found between intensity of H. pylori infection and severity of mucosal injury （rs=0.308, P〈0.05）. Conclusions： Long-term, lowdose, enteric-coated aspirin could cause gastroduodenal mucosal injury. H. pylori infection, smoking and age are all risk factors, but H. pylori infection seems to be the major risk factor.

关 键 词：阿司匹林 片剂 肠衣 胃黏膜 肠黏膜 损伤 

分 类 号：R595.3[医药卫生—内科学]