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目的探讨老年人服用非甾体类抗炎药(NSAIDs)致上消化道出血的临床及内镜特征。方法回顾性分析2003～2007年5年因上消化道出血住院患者的临床资料,依据1周内是否服用过NSAIDs,分为NSAIDs组和非NSAIDs组,对临床资料及内镜检查结果进行对比分析。结果 753例非食管胃静脉曲张上消化道出血住院患者中有76例(10.1%)发病前1周内有服用过NSAIDs药物史。比较两组患者性别、幽门螺杆菌感染情况,出血程度等差异无统计学意义(P>0.05),但NSAIDs组年龄明显偏大,伴有心脑血管病和骨关节病,出血前常无消化道症状,与非NSAIDs组相比差异有统计学意义(P<0.01)。NSAIDs组内镜检查以胃溃疡和糜烂出血为主要病变,与非NSAIDs组相比有非常显著性差异(P<0.01)。结论老年人应尽量减少NSAIDs的使用,必须服用者应注意观察上消化道症状,必要时加服胃黏膜保护剂干预以减少或预防胃肠道不良反应。
Objective To investigate the clinical and endoscopic features of upper gastrointestinal bleeding induced by non-steroidal anti-inflammatory drugs (NSAIDs) in the elderly. Methods The clinical data of hospitalized patients with upper gastrointestinal bleeding from 2003 to 2007 were retrospectively analyzed. According to whether NSAIDs were taken within 1 week, the patients were divided into NSAIDs group and non-NSAIDs group, and the clinical data and endoscopic findings were compared . RESULTS: Seventy-five (10.1%) hospitalized patients with non-esophageal varices of the upper gastrointestinal tract had a history of taking NSAIDs within 1 week prior to onset. There was no significant difference between the two groups in terms of sex, Helicobacter pylori infection and bleeding degree (P> 0.05). However, the age of NSAIDs group was significantly larger with cardio-cerebrovascular disease and osteoarthrosis. Compared with non-NSAIDs group, the difference was statistically significant (P <0.01). NSAIDs group of endoscopic examination of gastric ulcer and bleeding as the main lesion erosion, and non-NSAIDs group compared to a very significant difference (P <0.01). Conclusion The elderly should try to reduce the use of NSAIDs, the user must observe the upper gastrointestinal symptoms, if necessary, add gastric mucosal protective agent intervention to reduce or prevent gastrointestinal adverse reactions.