Johnsen S P, Sørensen H T, Mellemkjoer L, Blot W J, Nielsen G L, McLaughlin J K, Olsen J H
Department of Epidemiology and Social Medicine, University of Aarhus, Denmark.
Thromb Haemost. 2001 Aug;86(2):563-8.
The incidence of hospitalisation for upper GI bleeding with use of oral anticoagulants (OA) alone or in combination with other drugs was examined in a cohort of 4,204 users of OA, identified through record linkage between a population-based prescription database and a hospital discharge registry in Denmark, and compared with the incidence in the general population not exposed to OA. The standardised incidence ratio (SIR) was 2.8 (95% CI = 1.6-4.5) for use of OA alone. SIRs tended to be higher for use of OA combined with acetaminophen alone (4.4, 95% CI = 1.2-11.4), non-aspirin NSAIDs alone (8.0, 95% CI = 2.1 to 20.4) or aspirin/corticosteroids alone (3.8, 95% CI = 0.8-11.0), respectively. These results indicate that use of OA is associated with a significantly increased risk of upper GI bleeding, with still higher risks associated with the concomitant use of other medications including acetaminophen. Further research is needed to clarify the extent to which drugs interacting with oral anticoagulants may cause GI bleeding and the mechanisms through which these associations operate.
通过丹麦基于人群的处方数据库与医院出院登记处之间的记录链接，在4204名口服抗凝剂（OA）使用者队列中，研究了单独使用OA或与其他药物联合使用时上消化道出血的住院发生率，并与未接触OA的普通人群的发生率进行了比较。单独使用OA时的标准化发病率比（SIR）为2.8（95%CI=1.6-4.5）。单独将OA与对乙酰氨基酚联合使用时的SIR往往更高（4.4，95%CI=1.2-11.4），单独与非阿司匹林非甾体抗炎药联合使用时为（8.0，95%CI=2.1至20.4），或单独与阿司匹林/皮质类固醇联合使用时为（3.8，95%CI=0.8-11.0）。这些结果表明，使用OA与上消化道出血风险显著增加相关，与包括对乙酰氨基酚在内的其他药物同时使用时风险更高。需要进一步研究以阐明与口服抗凝剂相互作用的药物可能导致胃肠道出血的程度以及这些关联的作用机制。
