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目的探讨非甾体类抗炎药(NSAIDs)相关消化道溃疡伴出血患者的临床特点及内镜特征。方法收集2014年1月至2016年9月我院收治的上消化道溃疡出血患者176例,其中2周内服用过NSAIDs的患者75例作为NSAIDs组,未服用过NSAIDs的患者101例作为非NSAIDs组,比较两组患者临床特点及内镜特征。结果NSAIDs组患者年龄(63.79±10.94)岁,非NSAIDs组年龄(50.03±12.95)岁,两组年龄比较有统计学差异(P=0.024);出血前无消化道症状的比例:NSAIDs组42例(56.0%),非NSAIDs组25例(24.7%),两组比较有统计学差异(P=0.000);幽门螺旋杆菌(H.pylori)感染比例NSAIDs组为56.0%,与非NSAIDs组(37.6%)比较差异有统计学意义(P=0.015);而两组患者性别、吸烟史、饮酒史、既往有消化道溃疡或出血史的比例比较,差异无统计学意义(P均>0.05);两组患者胃镜发现胃溃疡、多发复合溃疡、十二直肠球部溃疡的溃疡部位构成比不同(P=0.000),NSAIDs组胃溃疡、多发复合溃疡发病比例大于非NSAIDs组,差异有统计学意义(P=0.017,P=0.034),而十二指肠球部溃疡发病比例小于非NSAIDs组,差异有统计学意义(P=0.000)。结论NSAIDs相关消化性溃疡出血在高龄中多见,出血前症状隐匿,H.pylori感染比例较非NSAIDs高,且两组患者胃镜发现溃疡部位的构成比不同。
Objective To investigate the clinical characteristics and endoscopic features of non-steroidal anti-inflammatory drugs (NSAIDs) associated with peptic ulcer with hemorrhage. Methods A total of 176 patients with upper gastrointestinal ulcer bleeding admitted in our hospital from January 2014 to September 2016 were collected. Among them, 75 patients who took NSAIDs within 2 weeks as NSAIDs group and 101 patients who did not take NSAIDs as non-NSAIDs Group, the clinical features and endoscopic features of two groups were compared. Results The age of patients in the NSAIDs group (63.79 ± 10.94) years and the non-NSAIDs group (50.03 ± 12.95) years old were statistically significant (P = 0.024). The proportion of non-gastrointestinal symptoms in the NSAIDs group was 42 (56.0%) in the non-NSAIDs group and 25 (24.7%) in the non-NSAIDs group (P = 0.000). The proportion of H.pylori infection in the NSAIDs group was 56.0% %) (P = 0.015). There was no significant difference between the two groups in gender, smoking history, drinking history, past history of peptic ulcer or bleeding (all P> 0.05). Gastric endoscopy revealed gastric ulcer, multiple complex ulcer and ulceration of duodenal ulcer in different groups (P = 0.000). The incidence of gastric ulcer and multiple ulcer in NSAIDs group was higher than that in non-NSAIDs group, the difference was statistically significant (P = 0.017, P = 0.034). However, the incidence of duodenal ulcer was lower than that of non-NSAIDs group (P = 0.000). Conclusion The bleeding of peptic ulcer associated with NSAIDs is more common in elderly patients. The symptoms before occlusion are hidden, and the proportion of H.pylori infection is higher than that of non-NSAIDs. The constituent ratio of ulcer in the two groups is different.