Fujii Takaaki, Nakabayashi Toshihiro, Hashimoto Shinji, Kuwano Hiroyuki
Department of General Surgical Science, Graduate School of Medicine, Gunma University 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan.
Hepatogastroenterology. 2009 Jul-Aug;56(93):1241-4.
BACKGROUND/AIMS: Aspirin significantly increases the risk of peptic ulcer. Since it remains to be determined whether gastroprotective agents should be used routinely in patients without risk factors who are taking aspirin, more risk factors for aspirin-related peptic ulcer should be detected. In the present study was investigated the effects of aspirin on upper gastrointestinal ulcer and potent risk factor for peptic ulcer associated with aspirin in a case-control study.
It was identified 137 newly diagnosed gastroduodenal ulcer cases from endoscopic examinees in the Gunma Prefectural Cardiovascular Center. Two controls per case were selected according to sex and age, and we determined 274 controls. It was calculated OR and 95% CI of peptic ulcer for serum triglycerides.
The use of low-dose aspirin without gastroprotective agents was found to be associated with the risk of peptic ulcer. High serum triglycerides were associated only with aspirin-related peptic ulcer. In contrast, no elevated OR of peptic ulcer was shown in cases without aspirin.
The present study results suggest that hypertriglycerides might be one of the risk factors for peptic ulcer caused by aspirin. These findings indicate that gastroprotective therapy should be considered for preventing peptic ulcer associated with low-dose aspirin in patients with hypertriglyceridemia.
背景/目的：阿司匹林显著增加消化性溃疡的风险。由于对于服用阿司匹林但无危险因素的患者是否应常规使用胃保护剂仍有待确定，因此应检测更多与阿司匹林相关的消化性溃疡危险因素。在本病例对照研究中，研究了阿司匹林对上消化道溃疡的影响以及与阿司匹林相关的消化性溃疡的潜在危险因素。
从群马县心血管中心的内镜检查者中确定了137例新诊断的胃十二指肠溃疡病例。根据性别和年龄为每个病例选择两名对照，共确定了274名对照。计算了血清甘油三酯与消化性溃疡的比值比（OR）和95%可信区间（CI）。
发现使用无胃保护剂的低剂量阿司匹林与消化性溃疡风险相关。高血清甘油三酯仅与阿司匹林相关的消化性溃疡有关。相比之下，未服用阿司匹林的病例中消化性溃疡的OR未升高。
本研究结果表明，高甘油三酯血症可能是阿司匹林所致消化性溃疡的危险因素之一。这些发现表明，对于高甘油三酯血症患者，应考虑采用胃保护疗法来预防与低剂量阿司匹林相关的消化性溃疡。
