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目的 研究非甾体抗炎药 (NSAIDs)所致胃十二指肠溃疡并出血的临床特点及幽门螺杆菌对溃疡特点的影响。方法 调查我院 1997年 1月至 2 0 0 1年 12月间因胃十二指肠球部溃疡并出血收住院治疗患者的临床资料 ,根据入院前 1周内有无服用NSAIDs史将患者分为两组 ,对两组患者的临床资料进行分析比较。结果 服药组 86例 ,未服药组 36 0例。服药组患者的年龄更高 ,血红蛋白下降更明显 (P =0 .0 0 4 ) ,胃溃疡和复合溃疡、多发溃疡及大溃疡在服药组更多见 (P <0 .0 0 1)。未服药组幽门螺杆菌 (Hp)的感染率为72 .5 % ,服药组为 5 3.4 % (P =0 .0 0 1)。进一步的研究发现 ,Hp感染状态对NSAIDs相关溃疡并出血的临床特点无明显影响 ,但胃黏膜糜烂更常见 (P <0 .0 5 )。结论 应加强对NSAIDs相关性胃十二指肠溃疡并出血临床特点的认识 ,尽量减少NSAIDs的不良反应
Objective To investigate the clinical characteristics of gastroduodenal ulcer caused by non-steroidal anti-inflammatory drugs (NSAIDs) and bleeding and the influence of Helicobacter pylori on the characteristics of ulcer. Methods The clinical data of patients hospitalized for gastroduodenal ulcer and bleeding from January 1997 to December 2001 in our hospital were investigated. According to the history of taking NSAIDs within one week before admission, For the two groups, the clinical data of two groups were analyzed and compared. Results 86 cases took medication group and 36 cases did not take medication group. Patients in the medication group were older and hemoglobin decreased more significantly (P = .040). Gastric ulcer and complex ulcer, multiple ulcer and large ulcer were more common in the medication group (P <0.01). The infection rate of H.pylori (Hp) in non-medication group was 72.5% and in medication group was 53.4% (P = 0.010). Further studies found that Hp infection had no significant effect on the clinical features of NSAIDs-associated ulceration and bleeding, but gastric mucosal erosion was more common (P <0.05). Conclusion The understanding of the clinical characteristics of NSAIDs-associated gastroduodenal ulcer and bleeding should be strengthened to minimize the adverse reactions of NSAIDs