缺血性心脏病患者低剂量阿司匹林所致胃十二指肠黏膜损伤的内镜检查
Endoscopic survey of low-dose-aspirin-induced gastroduodenal mucosal injuries in patients with ischemic heart disease.
作者信息
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
机构信息
Department of Gastroenterology, Hokko Memorial Hospital, Sapporo, Japan.
出版信息
J Gastroenterol Hepatol. 2008 Dec;23 Suppl 2:S234-6. doi: 10.1111/j.1440-1746.2008.05411.x.
BACKGROUND AND AIM
Low-dose aspirin is effective for the prevention of cardiovascular and cerebrovascular events, but the frequency of gastrointestinal injuries among users of low-dose aspirin in Japan is currently unknown. In the present study endoscopic examination was performed to investigate the frequency of gastroduodenal injuries associated with low-dose aspirin in patients with ischemic heart disease (IHD).
METHODS
Screening upper endoscopic examinations were prospectively performed on 131 patients with IHD who were not receiving antiulcer treatment. Endoscopic findings such as ulcers and flat erosions were assessed as mucosal injuries.
RESULTS
Mucosal injuries were found in 62 of 101 (61.4%) low-dose aspirin users and three of 30 (10%) nonaspirin users. There were significantly more mucosal injuries among low-dose aspirin users than among the non-users (P<0.0001). Gastroduodenal ulcers were found in 19 of 101 (18.8%) low-dose aspirin users compared with one of 30 (3.3%) nonaspirin users. The frequency of mucosal injuries was not associated with the duration of aspirin treatment.
CONCLUSION
Endoscopy frequently reveals low-dose aspirin-induced gastroduodenal injuries in patients with IHD.
背景与目的
低剂量阿司匹林对预防心脑血管事件有效，但目前日本低剂量阿司匹林使用者中胃肠道损伤的发生率尚不清楚。在本研究中，进行了内镜检查以调查缺血性心脏病（IHD）患者中与低剂量阿司匹林相关的胃十二指肠损伤的发生率。
方法
对131例未接受抗溃疡治疗的IHD患者进行前瞻性上消化道内镜筛查。将溃疡和扁平糜烂等内镜检查结果评估为黏膜损伤。
结果
101例低剂量阿司匹林使用者中有62例（61.4%）发现黏膜损伤，30例非阿司匹林使用者中有3例（10%）发现黏膜损伤。低剂量阿司匹林使用者中的黏膜损伤明显多于非使用者（P<0.0001）。101例低剂量阿司匹林使用者中有19例（18.8%）发现胃十二指肠溃疡，而30例非阿司匹林使用者中有1例（3.3%）发现胃十二指肠溃疡。黏膜损伤的发生率与阿司匹林治疗的持续时间无关。
结论
内镜检查经常发现IHD患者存在低剂量阿司匹林引起的胃十二指肠损伤。
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