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日本低剂量阿司匹林使用者的胃十二指肠溃疡临床特征。

Clinical features of gastroduodenal ulcer in Japanese patients taking low-dose aspirin.

机构信息

Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.

出版信息

Dig Dis Sci. 2010 Aug;55(8):2270-4. doi: 10.1007/s10620-009-1009-8. Epub 2009 Nov 20.

Abstract

BACKGROUND AND AIM

The risks of peptic ulcer complications increase in association with low-dose aspirin (LDA) use. The endoscopic findings and clinical features of gastroduodenal ulcer have not been thoroughly investigated in patients taking LDA.

METHOD

We classified 1,041 gastroduodenal ulcer patients into three groups [patients taking LDA (group A), patients taking nonaspirin nonsteroidal anti-inflammatory drug (NSAID) (group N), and patients taking neither aspirin nor nonaspirin NSAID (group C)] and 241 bleeding gastroduodenal ulcer patients into three corresponding groups (groups a, n, and c). We investigated the clinical features, endoscopic characteristics, and endoscopic treatment of the hemorrhagic lesion in the gastroduodenal ulcer patients taking LDA and compared them with those of the other groups.

RESULTS

The frequency of bleeding events such as hematemesis, melena, and anemia was significantly higher in group A and N than in group C. The percentage of ulcers located in the antrum was higher in group A and N than in group C, and also higher in group a and n than in group c. The percentage of ulcers located in the body, fundus, and cardia was significantly higher in the bleeding patients than in all gastroduodenal ulcer patients. The percentage of cases that required additional endoscopic treatment in group a was higher than in group c. Duration of hospitalization of group a was significantly longer than that of group c.

CONCLUSION

These results indicate that it is very important to prevent LDA-induced gastroduodenal ulcer complications, including bleeding.

摘要

背景与目的

低剂量阿司匹林(LDA)的使用会增加消化性溃疡并发症的风险。在服用 LDA 的患者中,尚未彻底研究胃十二指肠溃疡的内镜表现和临床特征。

方法

我们将 1041 例胃十二指肠溃疡患者分为三组[服用 LDA 的患者(A 组)、服用非阿司匹林非甾体抗炎药(NSAID)的患者(N 组)和未服用阿司匹林或非阿司匹林 NSAID 的患者(C 组)],并将 241 例出血性胃十二指肠溃疡患者分为三组(a、n 和 c 组)。我们调查了服用 LDA 的胃十二指肠溃疡患者的出血性病变的临床特征、内镜特征和内镜治疗,并将其与其他组进行了比较。

结果

A 组和 N 组呕血、黑便和贫血等出血事件的发生率明显高于 C 组。A 组和 N 组的溃疡位于胃窦的百分比高于 C 组,a 组和 n 组的溃疡位于胃窦的百分比也高于 c 组。位于胃体、胃底和贲门的溃疡在出血患者中明显多于所有胃十二指肠溃疡患者。A 组需要额外内镜治疗的病例百分比高于 C 组。A 组的住院时间明显长于 C 组。

结论

这些结果表明,预防 LDA 引起的胃十二指肠溃疡并发症,包括出血,非常重要。

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