Niv Yaron, Battler Alex, Abuksis Galia, Gal Eyal, Sapoznikov Boris, Vilkin Alex
Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
Dig Dis Sci. 2005 Jan;50(1):78-80. doi: 10.1007/s10620-005-1281-1.
Aspirin is widely used for its antiplatelet activity, but it harbors a risk of severe adverse gastrointestinal effects, such as bleeding and perforation, especially in elderly people. Our aim to assess the prevalence of upper gastrointestinal lesions and the effect of aspirin on the gastrointestinal mucosa in asymptomatic subjects taking minidose aspirin (100 to 325 mg per day) for more than 3 months. A prospective, open design was used. Patients attending the ophthalmology and cardiology outpatient clinics who had a medical history of more than 3 months of regular aspirin consumption were referred for esophagogastroduodenoscopy (EGD). Of the 90 patients referred for EGD, 44 were symptomatic (epigastric pain or dyspepsia) and were excluded from the study. The 46 asymptomatic patients included 22 men and 24 women of mean age 70 +/- 10 years (range, 36 to 87 years); 32% were current or former smokers. Mean daily aspirin dose was 129.34 +/- 76.61 mg. Only 24% were taking a gastroprotective agent. EGD revealed ulcer or erosions in 47.83% of the patients: erosive gastroduodenitis in 13 patients, gastric ulcer in 14, duodenal ulcer in 2, and gastric and duodenal ulcers in 2. Urease test for Helicobacter pylori infection was positive in 26%. Univariate and multivariate analysis revealed no factor other than aspirin predictive of a positive endoscopy. Minidose aspirin treatment is associated with a high prevalence of ulcerations of the stomach and duodenum.
阿司匹林因其抗血小板活性而被广泛使用，但它存在严重胃肠道不良反应的风险，如出血和穿孔，尤其是在老年人中。我们的目的是评估服用小剂量阿司匹林（每天100至325毫克）超过3个月的无症状受试者上消化道病变的患病率以及阿司匹林对胃肠道黏膜的影响。采用前瞻性开放设计。有超过3个月定期服用阿司匹林病史的眼科和心脏病科门诊患者被转诊进行食管胃十二指肠镜检查（EGD）。在转诊进行EGD的90名患者中，44名有症状（上腹部疼痛或消化不良），被排除在研究之外。46名无症状患者包括22名男性和24名女性，平均年龄70±10岁（范围36至87岁）；32%为当前或既往吸烟者。平均每日阿司匹林剂量为129.34±76.61毫克。只有24%的患者正在服用胃保护剂。EGD显示47.83%的患者有溃疡或糜烂：13例为糜烂性胃十二指肠炎症，14例为胃溃疡，2例为十二指肠溃疡，2例为胃和十二指肠溃疡。幽门螺杆菌感染的尿素酶试验阳性率为26%。单因素和多因素分析显示，除阿司匹林外，没有其他因素可预测内镜检查结果为阳性。小剂量阿司匹林治疗与胃和十二指肠溃疡的高患病率相关。
