上消化道出血与非甾体类抗炎药物的关系  

Correlation between Upper Gastrointestinal Bleeding and Nonsteroidal Anti-inflammatory Drug

作　　者：江一鸣 黄开红[2] 李楚强[2] 陈为宪[2] 王连源[2] 朱兆华[2] 

机构地区：[1]广东省台山市人民医院消化科,529200 [2]中山大学附属第二医院消化科

出　　处：《岭南急诊医学杂志》2007年第1期15-17,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨非甾体抗炎药(NSAIDs)诱发上消化道出血(uppergastrointestinalbleeding,UGIB)的临床流行病学特点。方法:调查中山大学附属第二医院及广东省台山市人民医院2000年1月～2006年10月间因上消化道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366例患者,其中服药组103例,未服药组263例。2组病人在性别、出血方式、胃及十二指肠病变的具体部位以及是否需要内镜治疗等方面的差异无显著性;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<0.01);胃溃疡和复合溃疡、多发溃疡在服药组更多见(P<0.01),而未服药组幽门螺杆菌(Hp)的感染率与服药组的感染率有显著差异,分别为26.24%和65.05%(P<0.05)。进一步的研究发现,患者年龄和Hp感染状态和上消化道出血史对NSAIDs相关的上消化道出血的临床特点有明显影响。结论:应加强对NSAIDs相关性上消化道出血临床特点的认识,尽量减少NSAIDs的不良反应。Objective： To investigate the clinical epidemiological features of upper gastrointestinal bleeding （UGIB） induced by non-steroidal anti-inflammatory drugs（NSAIDs）. Methods： Patients who were hospitalized in our ward because of UGIB from Jan, 2000 to Dec, 2006 were divided into two groups according to consumption of NSAIDs or not in the week previous to the onset of bleeding. Results： 366 patients were investigated with 103 in NSAIDs group and 263 in non-NSAIDs group. There was no significant difference in sex, way of bleeding, 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 〈 0.001）. There was more gastric ulcer and complex ulcer in the NSAIDs group than in non-NSAIDs group （P 〈 0.001）. NSAIDs users had more erosion and ulcers （P 〈 0.001 ）. Helicobacer priori （Hp） was present in 65.05%% of the non-NSAIDs group and 26.24% of the NSAIDs group （P 〈 0.05）. In an another study, we found that age of the patients, history of UGIB, Hp state affect the clinical characteristics of NSAIDs UGIB. Conclusions： The clinical characteristics of NSAIDs associated UGIB should be better understood so as to decrease the occurrence of NSAIDs UGIB and its complication.

关 键 词：非甾体抗炎药 上消化道出血 

分 类 号：R573.2[医药卫生—消化系统]