抗血小板药物消化道损伤预防与处理.pptVIP

Hp感染增加溃疡危险性 % 溃疡病人 NSAID+ Hp+ NSAID+ Hp- NSAID- Hp+ NSAID- Hp- O.R. 2.4 O.R. 2.1 Huang et al. Lancet 2001 Meta-analysis of 12 studies consisting of 1901 patients NSAID 造成的反流性食管炎 Reflux esophagitis LA Grades A–D. Avidan et al 2001 Reflux esophagitis: the presence of definite mucosal breaks or metaplasia of the esophagus, visible under endoscopy. Among patients taking non-selective NSAIDs for osteoarthritis, the prevalence rate of erosive esophagitis was 21%. A B C D 大溃疡 多发性 GU DU 无痛性 80%有严重NSAID相关GI并发症的病人以前都无GI症状 不少患者以溃疡出血或穿孔为首发症状 Am J Med 1998 NSAIDs相关溃疡 胃镜检查结果 慢性胃炎(活动期)伴糜烂 胃镜检查结果 十二指肠溃疡(活动