心血管疾病住院患者阿司匹林使用情况及其消化道损伤情况  

Aspirin usage and gastrointestinal injury in hospitalized patient with cardiovascular disease

作　　者：都丽萍[1] 师春焕 唐筱婉 梅丹[1] 郑月宏[3] Du Liping;Shi Chunhuan;Tang Xiaowan;Mei Dan;Zheng Yuehong(Department of Pharmacy,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Pharmacy,Dongying People's Hospital,Dongying 257091,Shandong;Department of Vascular Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院药剂科,北京100730 [2]东营市人民医院药剂科,山东东营257091 [3]中国医学科学院北京协和医学院北京协和医院血管外科,北京100730

出　　处：《血管与腔内血管外科杂志》2023年第1期7-10,26,共5页Journal of Vascular and Endovascular Surgery

基　　金：首都卫生发展科研专项项目(首发2018-3-4017);中央高水平医院临床科研专项(2022-PUMCH-A-199)。

摘　　要：目的分析心血管疾病住院患者阿司匹林使用情况及其消化道损伤情况。方法收集2021年1—6月于中国医学科学院北京协和医学院北京协和医院使用阿司匹林肠溶片治疗的1213例心血管疾病住院患者的临床资料。统计患者抗血小板药物、抗凝药物、非甾体抗炎药(NSAID)、糖皮质激素等使用情况,分析患者消化道保护药物的使用情况及服用阿司匹林引起的相关消化道损伤危险因素,观察患者服用阿司匹林引起的消化道症状。结果970例患者存在消化道损伤危险因素,包括联合双联抗血小板药物、年龄≥65岁、联合抗凝药物、合并消化系统疾病、联合糖皮质激素类药物、联合其他NSAID,其中,联合双联抗血小板药物患者比例最高,其次为年龄≥65岁。使用消化道保护药物239例,危险因素≥3个消化道保护药物使用率明显高于1~2个危险因素,差异有统计学意义(P﹤0.01)。心内科患者消化道保护药物使用率为23.09%(157/680),明显高于血管外科的15.38%(82/533),差异有统计学意义(P﹤0.01)。78例患者发生消化道不良反应,其中6例有便血、便潜血阳性等消化道出血表现,5例暂停阿司匹林,1例换用吲哚布芬后消化道出血症状均得到了缓解,未发生大出血。年龄≥65岁、联合其他抗栓药物、未使用消化道保护药物均是心血管疾病住院患者服用阿司匹林后发生消化道损伤的危险因素(P﹤0.05)。结论临床医师尤其是血管外科医师应对服用阿司匹林后消化道损伤的高危患者给予高度重视,尤其是高龄、联合其他抗栓药物的患者,必要时应给予预防性消化道保护药物。Objective To investigate the aspirin usage and gastrointestinal injury in hospitalized patient with cardiovascular disease.Method The clinical data of 1213 hospitalized patients with cardiovascular diseases who were treated with aspirin in Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College from January to June,2021 were selected.The usage of antiplatelet drug,anticoagulant,non-steroidal anti-inflammatory drug(NSAID),glucocorticoid were counted,the usage of gastrointestinal protective medication and risk factor of aspirin related gastrointestinal injury were analyzed,the gastrointestinal symptom caused by aspirin was observed.Result A total of 970 patients had risk factors for gastrointestinal injury,which included the combined with antiplatelet drug,≥65 years,combined with anticoagulant,concomitant digestive disease,combined with glucocorticoid and other NSAID,the highest proportion of patient combined with antiplatelet,followed by proportion of patients≥65years.A total of 239 patients used gastrointestinal protective drugs,which were more commonly used in patients with≥3risk factors than those with 1-2 risk factors,the difference was statistically significant(P<0.01).The proportion of patients in department of cardiology who used gastrointestinal protective drug was 23.09%(157/680),significantly higher than that in department of cardiac surgery 15.38%(82/533),the difference was statistically significant(P<0.01).A total of 78 patients experienced gastrointestinal symptom,among which 6 patients had hemafecia and positive occult blood in stool,5 patients were relieved of gastrointestinal bleeding symptom after aspirin suspension,1 patient was replaced with indolbuprofen,and no massive bleeding occurred.Age≥65 years old,combined with other antithrombotic drug,and no use of gastrointestinal protective drug were all risk factors for gastrointestinal injury in hospitalized patients with cardiovascular diseases after taking aspirin(P<0.05).Conclusion Clinicians

关 键 词：阿司匹林 消化道损伤 消化道保护药物 

分 类 号：R543[医药卫生—心血管疾病]