Llorente Melero M J, Tenías Burillo J M, Del Val Antoñana A, Zaragoza Marcet A
Servicio de Medicina Interna, Hospital "Lluis Alcanyis", Xátiva, Valencia, 46800, España.
Rev Esp Enferm Dig. 1999 Jul;91(7):497-507.
To establish the influence of nonsteroidal anti-inflammatory drugs (NSAIDs) on the clinical course of upper gastrointestinal bleeding (UGIB), we designed a longitudinal cohort study to assess the effect of prior use of these drugs on several outcome variables in patients with UGIB.
164 (46.6%) of 352 patients with UGIB consumed NSAIDs in the week previous to the onset of bleeding. This group had significantly fewer previous episodes of peptic ulcer and UGIB (p < 0.01), more associated comorbidity, and increased use of steroids (p < 0.05). On endoscopic examination, gastric ulcer was the most frequent lesion in patients with NSAIDs as compared to duodenal ulcer in patients without NSAID use (p < 0.0001). There were no differences in the multivariate analysis between groups regarding lowest hemoglobin level, need for transfusion, stability of bleeding, surgical or endoscopic management, depth of lesions and hospital stay.
a relevant proportion of patients admitted for UGIB had used NSAIDs during the previous week. The most frequent lesion in this group was gastric ulcer. In our study the clinical course of NSAID-associated UGIB was similar to that in other nonvariceal types of bleeding.
为确定非甾体抗炎药（NSAIDs）对上消化道出血（UGIB）临床病程的影响，我们设计了一项纵向队列研究，以评估这些药物的既往使用对UGIB患者若干结局变量的影响。
352例UGIB患者中有164例（46.6%）在出血发作前一周服用了NSAIDs。该组既往消化性溃疡和UGIB发作次数明显较少（p<0.01），合并症更多，且类固醇使用增加（p<0.05）。在内镜检查中，与未使用NSAIDs的患者十二指肠溃疡相比，使用NSAIDs的患者胃溃疡是最常见的病变（p<0.0001）。在多变量分析中，两组在最低血红蛋白水平、输血需求、出血稳定性、手术或内镜治疗、病变深度和住院时间方面没有差异。
因UGIB入院的患者中有相当比例在过去一周内使用了NSAIDs。该组最常见的病变是胃溃疡。在我们的研究中，NSAIDs相关UGIB的临床病程与其他非静脉曲张性出血类型相似。
