长期服用阿司匹林的中老年男性保健人群消化道黏膜损伤的胃镜随访观察  

Long-term follow up after gastro-endoscopy screening for age ≥45 years male health care population with long-term aspirin used in gastrointestinal mucosal injury

作　　者：陈峥[1] 万军[1] 杜海涛[1] 苏斌斌[1] 陈倩倩[1] 

机构地区：[1]解放军总医院南楼消化内科,北京100853

出　　处：《中华医学杂志》2015年第20期1590-1594,共5页National Medical Journal of China

摘　　要：目的 分析长期服用阿司匹林的中老年男性保健人群胃镜随访中消化道黏膜损伤检出数目及严重程度的动态变化趋势.方法 回顾性分析1999年10月至2014年4月解放军总医院长期服用阿司匹林（至少3年以上）并进行胃镜定期随访检查的中老年保健人群,收集其一般临床资料、胃镜报告、服药信息.采用单因素重复测量方法分析消化道黏膜损伤在随访过程中历年的检出数目、病变类型、严重程度和不同部位分布的变化规律.结果 共收集259例中老年男性保健者、共2 281例次胃镜检查结果;年龄45 -91岁,平均67岁,平均随访5年.分别有239、103、20例随访至第5、10、15年,每例平均随访8次.共检出消化道黏膜损伤的数目为4 442个,平均为2个/例次.其中随访第1年黏膜损伤的检出数目多于初次检出数目（P＜0.05）,第2-15年黏膜损伤的检出数目均少于初次的检出数目（均P ＜0.05）.消化道黏膜损伤3种病变类型中,糜烂的检出数目高于点状出血灶和溃疡（均P ＜0.05）;点状出血灶多于溃疡（P＜0.05）.应用改良Lanza评分评价消化道黏膜损伤程度,整体呈现平缓下降的趋势.消化道黏膜损伤在胃窦、胃体处的检出数目明显高于其他各部位（均P ＜0.05）.结论 长期服用阿司匹林的中老年男性保健人群在胃镜随访过程中消化道黏膜损伤的检出数目和损伤程度均呈现平缓下降的趋势,但检出数目在开始服药的2年以内出现一过性的上升.在随访过程中消化道黏膜损伤最常见的病变类型是糜烂,损伤的部位主要集中在胃窦、胃体部.Objective To analyze the characteristics and trends of gastrointestinal mucosal injury for age ≥ 45 years male health care patients during gastro-endoscopic follow-up.Methods Endoscopic reports of age ≥ 45 years male health care patients with long-term aspirin undergoing gastroscopy from October 1999 to April 2014 were retrospectively reviewed.The proportion of different lesions,the distribution at different anatomic sites,and the trends of the number of gastrointestinal mucosal injury in different follow up years were analyzed.Results A total of 2 281 endoscopic reports of 259 health care cases aged ≥ 45 years with aspirin used 3 years at least were collected.After the initial gastroscopy screening,there are 239,103 and 20 cases followed up to the 5^th,10^th and 15^th years.The patients were between 45-91 years of age,their mean age was 67 years.The mean followed-up time was 5 years.In the follow-up process each patient had 8 gastroscopies performed.A total of 4 442 lesions were detected and the mean number was 2 per person for once.The number of gastrointestinal mucosal injuries were different.The number of the gastrointestinal mucosal injury of the 1 ^st year was higher than that of initial gastro-endoscopy （P〈0.05）.The numbers of the gastrointestinal mucosal injury of the 2^se-5^th years during the follow up period were lower than those of initial gastro-endoscopy （all P 〈 0.05）.The numbers of three different lesions of gastrointestinal mucosal injury were different （P 〈 0.05）.The number of erosion was more than petechia and ulcer （both P 〈 0.05）.The Modified Lanza＇s Score （MDS） were in descending trend during the follow up period.The numbers of gastrointestinal mucosal injury in different anatomic sites were different in the same follow-up years （all P 〈 0.05）.Conclusions The numbers and degree of gastrointestinal mucosal injury for middle aged and aged health care patients with long-term aspirin used during gastroendoscopic follow-up are in descending trend,however,

关 键 词：阿司匹林 胃肠道 胃镜检查 老年人 随访研究 

分 类 号：R573[医药卫生—消化系统]