Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Via E. Morosini, 30, 00153 Rome, Italy.
Intern Emerg Med. 2012 Aug;7(4):331-5. doi: 10.1007/s11739-011-0578-7. Epub 2011 Mar 31.
Non-steroidal anti-inflammatory drugs (NSAIDs) may cause gastroduodenal ulcers and its complications. Helicobacter pylori infection is recognized as an additional risk factor for ulcer development, its eradication in NSAIDs users being recommended. In this cross-sectional study, during a 1-week period, consecutive patients who were routinely visiting in 58 primary care clinics were enrolled. A questionnaire was used to collect clinical data on the patients who were chronically taking NSAIDs. Patients with age >65 years, a personal history of peptic ulcer, concomitant therapy with steroids, anti-coagulants, multiple NSAIDs, or relevant co-morbidities were considered at high risk for NSAIDs gastroduodenal complications. Data on H. pylori infection management were collected. Overall, H. pylori was searched for in 140 (16.1%) out of 869 patients receiving chronic NSAID therapy, and it was eventually cured in 43 (72.9%) of the infected cases. In detail, H. pylori status was not investigated in 670 (77.1%) of those patients at high risk of NSAID-related gastroduodenal lesions, including 516 patients ≥65 years old, and 154 younger, but with at least 1 adjunctive risk factor. In addition, 234 (35%) of these high-risk patients were not receiving any gastric mucosa protection. Our data find that H. pylori infection is investigated in fewer than one of every five NSAID-user patients in primary care. The low alertness towards such an infection in these patients suggests a need for prompt implementation of current guidelines.
非甾体抗炎药（NSAIDs）可能会导致胃十二指肠溃疡及其并发症。幽门螺杆菌感染被认为是溃疡发展的另一个危险因素，建议 NSAIDs 使用者根除幽门螺杆菌。在这项横断面研究中，在一周的时间内，连续招募了在 58 个初级保健诊所常规就诊的患者。使用问卷收集了长期服用 NSAIDs 的患者的临床数据。年龄>65 岁、有消化性溃疡病史、同时接受类固醇、抗凝剂、多种 NSAIDs 或相关合并症治疗的患者被认为有 NSAIDs 胃肠道并发症的高风险。收集了关于幽门螺杆菌感染管理的数据。总体而言，在接受慢性 NSAID 治疗的 869 名患者中，有 140 名（16.1%）进行了幽门螺杆菌检测，在感染的 43 名患者中（72.9%）最终治愈。详细来说，在有 NSAID 相关胃十二指肠病变高风险的 670 名患者（包括 516 名年龄≥65 岁的患者和 154 名年龄较小但至少有 1 个附加危险因素的患者）中，未对幽门螺杆菌状态进行调查。此外，这些高危患者中有 234 名（35%）未接受任何胃黏膜保护。我们的数据发现，在初级保健中，每五个 NSAID 使用者中只有不到一个接受了幽门螺杆菌感染的检查。这些患者对这种感染的警惕性较低，表明需要及时实施当前的指南。
