Nema Hiroaki, Kato Mototsugu, Katsurada Takehiko, Nozaki Youichi, Yotsukura Akihiko, Yoshida Izumi, Sato Katsuhiko, Kawai Yuko, Takagi Yasushi, Okusa Takanori, Takiguchi Shunichi, Sakurai Masayuki, Asaka Masahiro
Department of Gastroenterology, Hokko Memorial Hospital, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
J Clin Gastroenterol. 2009 Feb;43(2):130-2. doi: 10.1097/MCG.0b013e3181580e8a.
Low-dose aspirin is used for secondary prevention of ischemic heart disease and ischemic cerebrovascular disease. Currently, the frequency of gastrointestinal disorder among users of low-dose aspirin is unknown.
To investigate through endoscopic examination the frequency of gastroduodenal disorder associated with buffered and enteric-coated aspirin (ECA).
Screening upper endoscopic examinations were prospectively performed on 236 patients with ischemic heart disease. Endoscopic findings including ulcers and flat erosions were assessed as mucosal defects.
Mucosal defects were found in 92 of 190 (48.4%) users of low-dose aspirin and 6 of 46 (13.0%) nonusers. There were significantly more mucosal defects among users of low-dose aspirin than among those using no aspirin (P<0.0001). Mucosal defects were found in 54 of 98 (60.7%) users of buffered aspirin (BA), whereas 38 of 101 (37.6%) users of ECA had mucosal defects. Users of ECA had significantly fewer erosions than did those of BA (P=0.0015). The frequency of ulcer is similar between BA users and ECA users.
As endoscopy frequently reveals gastroduodenal disorder among low-dose aspirin users, both administration of BA and of enteric-coated aspirin warrant concern for gastroduodenal ulcer.
低剂量阿司匹林用于缺血性心脏病和缺血性脑血管疾病的二级预防。目前，低剂量阿司匹林使用者胃肠道疾病的发生率尚不清楚。
通过内镜检查调查与缓冲型和肠溶型阿司匹林（ECA）相关的胃十二指肠疾病的发生率。
对236例缺血性心脏病患者进行前瞻性上消化道内镜筛查。将包括溃疡和平坦糜烂在内的内镜检查结果评估为黏膜缺损。
190例低剂量阿司匹林使用者中有92例（48.4%）发现黏膜缺损，46例未使用者中有6例（13.0%）发现黏膜缺损。低剂量阿司匹林使用者的黏膜缺损明显多于未使用阿司匹林者（P<0.0001）。98例缓冲型阿司匹林（BA）使用者中有54例（60.7%）发现黏膜缺损，而101例ECA使用者中有38例（37.6%）发现黏膜缺损。ECA使用者的糜烂明显少于BA使用者（P=0.0015）。BA使用者和ECA使用者的溃疡发生率相似。
由于内镜检查经常发现低剂量阿司匹林使用者存在胃十二指肠疾病，因此使用BA和肠溶型阿司匹林均需关注胃十二指肠溃疡。
