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目的 研究非甾体抗炎药 (NSAIDs)相关性胃十二指肠溃疡并出血的临床特点。方法 调查我院 1 997年 1月～ 2 0 0 1年 1 2月间因胃十二指肠溃疡并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 446例患者 ,其中服药组 86例 ,未服药组 360例。 2组病人在性别、出血方式、既往消化性溃疡史、胃及十二指肠溃疡的具体部位、糜烂 ,以及是否需要内镜治疗等方面的差异无显著性。但是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 0 0 4 ) ;胃溃疡和复合溃疡、多发溃疡在服药组更多见 (P <0 0 0 1 ) ,而未服药组幽门螺杆菌 (Hp)的感染率较服药组更高 ,分别为 72 5 %和 53 4% (P =0 0 0 1 )。进一步的研究发现 ,患者年龄和Hp感染状态对NSAIDs相关溃疡并出血的临床特点无明显影响。结论 应加强对NSAIDs相关性胃十二指肠溃疡并出血临床特点的认识 ,尽量减少NSAIDs的不良反应。
Objective To study the clinical features of non-steroidal anti-inflammatory drugs (NSAIDs) associated with gastroduodenal ulcer and bleeding. Methods The clinical data of patients hospitalized for gastroduodenal ulcer bleeding from January 1997 to February 2011 in our hospital were investigated. According to the history of NSAIDs within 1 week before admission, patients were divided For 2 groups, the clinical data of 2 groups of patients were analyzed and compared. Results A total of 446 patients were enrolled in this study, 86 of which were in the medication group and 360 in the non-medication group. There was no significant difference in gender, bleeding pattern, previous history of peptic ulcer, specific location of gastric and duodenal ulcer, erosion, and the need for endoscopic treatment in the two groups. However, the patients in the medication group were older than those in the medication group, and hemoglobin decreased more significantly in the medication group (P = 0.0040). Gastric ulcer, multiple ulcer and multiple ulcer were more common in the medication group (P <0.01) ), While the infection rate of H.pylori (Hp) in non-medication group was higher than that in medication group (72.5% and 53.4%, respectively) (P = 0.00001). Further studies found that patient age and Hp infection status had no significant effect on the clinical characteristics of NSAIDs-associated ulceration and bleeding. Conclusions The clinical features of NSAIDs-associated gastroduodenal ulcer and bleeding should be strengthened, and the adverse reactions of NSAIDs should be minimized.