非甾体类抗炎药致上消化道出血366例临床剖析.docVIP

非甾体类抗炎药致上消化道出血366例临床剖析 　　【摘要】 目的 探讨非甾体类抗炎药(NSAIDs)诱发上消化道出血(PU)的临床流行病学特点。方法 调查中山大学孙逸仙纪念医院2002年1月至2009年1月间因上消化道出血收住院治疗366例患者,根据入院前1周内有无服用NSAIDs,将患者分为服药组(103例)及未服药组(263例),对两组患者的临床资料进行分析比较。结果 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(P0.01);胃溃疡和复合溃疡、多发溃疡在服药组更多见(P0.01),服药组幽门螺杆菌(Hp)的感染率与未服药组的感染率有显著差异,分别为65.05%和26.24%,(P0.05)。结论 应加强对NSAIDs相关性上消化道出血临床特点的认识,尽量减少NSAIDs的不良反应。 　　【关键词】 　　非甾体类抗炎药;上消化道出血 　　 　　Clinical analysis of 366 cases of upper gastrointestinal bleeding caused by non-steroidal anti-inflammatory drugs 　　CHEN Chu-xiong,MA Zai-hong,YE Lin.Deptartment of pharmacy,The Sun Yat-sen Hospital of Sun Yat-sen University,Guangzhou 510120,China 　　 　　【Abstract】 Objective To study the clinico-epidemiological features of the upper gastrointestinal bleeding caused by non-steroidal anti-inflammatory drugs.Methods 366 cases of upper gastrointestinal bleeding from Jan.2002 to Jan.2009 in The Sun Yat-sen Hospital of Sun Yat-sen University were investigated.Patients were divided into treated group(103 cases)and untreated group(263 cases)according to whether they had had NSAIDs in one week before admission.And the clinical data of the two groups of patients were analyzed.Results The treated group was older than the untreated group.Hemoglobin was significantly decreased in the treated group(P0.01).There were more gastric ulcer,complex ulcer and multiple ulcers in the treated group.The rate of Helicobacter Pylori(HP)Infection in treated group was obviously different from that in untreated group,which was 65.05%and 26.24%(P0.05).Conclusion The clinical characteristics of the upper gastrointestinal bleeding caused by non-steroidal anti-inflammatory drugs should be emphasized and we should reduce the adverse reactions to NSAIDs. 　　【Key words】 　　NSAIDs;Upper gastrointestinal bleeding 　　 　　非甾体类抗炎药(NSAIDs)是一种不含皮质激素、具有抗炎、镇痛、抗血栓、抗肿瘤作用的药物,其临床应用越来越广泛;据估计全世界每天约有 300 多万人服用此药,是目前处方量最大的药物之一;随着我国人口老龄化的加剧,为预防和治疗心脑血管等疾病,服用NSAIDs的老年人明显增多,而其引起的不良反应,尤其相关性上消化道出血突出[1]。笔者将本院2002年1月至2009年1月诊治的相关性上消化道出血病例进行了