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目的探讨服用阿司匹林的老年患者采用泮托拉唑与根除幽门螺杆菌治疗,对其胃及十二指肠损伤的影响。方法回顾性分析2014年12月至2015年12月收治的116例老年患者资料,所有患者均为服用阿司匹林超过3个月,且未进行相关的幽门螺杆菌根除治疗。将其按照随机数字表法分为试验组与对照组,各58例,分别给予泮托拉唑单药维持治疗30 d和根除幽门螺杆菌治疗14 d,治疗期间两组患者同时给予阿司匹林治疗。对比两组患者胃损伤发生情况、Hp根除率、病情改善比率及恶化比率等。结果试验组患者胃及十二指肠黏膜损伤严重程度明显低于对照组,差异有统计学意义(P<0.05);试验组、对照组患者Hp根除率分别为93.1%(54/58)、46.6%(27/58),差异有统计学意义(P<0.05);试验组患者病情恶化发生率为22.4%(13/58),明显低于对照组的50.0%(29/58),差异有统计学意义(P<0.05);试验组患者病情改善发生率为24.1%(14/58),明显高于对照组的8.6%(5/58),差异有统计学意义(P<0.05)。结论针对需要长期服用阿司匹林治疗的老年患者,不管是否合并其他药物进行根除幽门螺杆菌治疗,给予泮托拉唑单药维持治疗,均能对非甾体类消炎药物引发的胃及十二指肠黏膜损伤进行有效预防,提升患者Hp根除率和病情改善率,降低恶化率。
Objective To investigate the effect of pantoprazole and eradication of Helicobacter pylori in elderly patients taking aspirin on gastric and duodenal injury. Methods The data of 116 elderly patients who were treated from December 2014 to December 2015 were retrospectively analyzed. All of the patients were taking aspirin for more than 3 months without related H. pylori eradication. According to the random number table, they were divided into experimental group and control group, 58 cases in each group were given pantoprazole monotherapy for 30 days and Helicobacter pylori eradication for 14 days respectively. Both groups were treated with aspirin at the same time. Comparing the incidence of gastric injury, Hp eradication rate, disease improvement rate and worsening rate in two groups of patients. Results The severity of gastric and duodenal mucosal injury in test group was significantly lower than that in control group (P <0.05). The Hp eradication rates in test group and control group were 93.1% (54/58) 46.6% (27/58) respectively, the difference was statistically significant (P <0.05). The incidence of exacerbation was 22.4% (13/58) in the experimental group, which was significantly lower than that in the control group (50.0%, 29/58) (P <0.05). The incidence of disease improvement was 24.1% (14/58) in the experimental group, which was significantly higher than that in the control group (8.6%, 5/58) . Conclusion For the elderly patients who need long-term aspirin treatment, regardless of whether other drugs are combined for the treatment of Helicobacter pylori eradication, administration of the pantoprazole monotherapy can affect the stomach and duodenum induced by non-steroidal anti-inflammatory drugs Mucosal injury for effective prevention, improve patients with Hp eradication rate and disease improvement rate, reduce the rate of deterioration.