Mousavi Mirhadi, Salehimarzijarani Babak, Dadvar Zohreh, Jalalay Niloufar Yahyapour, Valizadeh Neda, Sotoudeh Houman, Zali Mohammadreza
Shahid Beheshti University of Medical Sciences, Gastroenterology, Tehran, Islamic Republic of Iran.
Turk J Gastroenterol. 2013;24(2):93-8. doi: 10.4318/tjg.2013.0547.
BACKGROUND/AIMS: Gastrointestinal disorders are important side effects of aspirin therapy, even if the low-dose enteric-coated form is administered. The aim of the current study was to present the upper and lower endoscopic features of patients with gastrointestinal hemorrhage using low-dose enteric-coated aspirin.
This prospective study was conducted among 633 consecutive patients with gastrointestinal hemorrhage who admitted to our tertiary referral hospital for endoscopy assessment. Patients were divided into two groups as low-dose aspirin users (n=168) and non-aspirin users (n=495). Aspirin users included those who were taking 80-100 mg of enteric-coated aspirin per day.
Ulcer lesions were found in 78 patients in the aspirin user group and in 113 patients in the control group. Prevalence of duodenal ulcer was statistically similar between the two groups; however, gastric ulcer was seen more in the aspirin-user group. The use of low-dose aspirin could strongly predict gastric ulcers in the patients examined by endoscopy (p<0.001). Overall prevalence of peptic ulcer disease in those with confirmed Helicobacter pylori infection was significantly higher than in non-infected ones (p<0.001). The presence of this infection was strongly associated with peptic ulcer disease in the aspirin-user group (p<0.001). Multivariable analysis also demonstrated that the use of aspirin had a main triggering effect on short-term mortality following gastrointestinal endoscopy (p=0.003).
Low-dose enteric-coated aspirin causes significant gastric endoscopic lesions and even predicts mortality due to progression of gastrointestinal disorders.
背景/目的：胃肠道疾病是阿司匹林治疗的重要副作用，即使使用低剂量肠溶制剂也是如此。本研究的目的是呈现使用低剂量肠溶阿司匹林的胃肠道出血患者的上消化道和下消化道内镜特征。
本前瞻性研究在633例因内镜评估连续入住我院三级转诊医院的胃肠道出血患者中进行。患者分为两组，即低剂量阿司匹林使用者（n = 168）和非阿司匹林使用者（n = 495）。阿司匹林使用者包括那些每天服用80 - 100 mg肠溶阿司匹林的患者。
阿司匹林使用者组有78例患者发现溃疡病变，对照组有113例患者发现溃疡病变。两组十二指肠溃疡的患病率在统计学上相似；然而，胃溃疡在阿司匹林使用者组中更为常见。在内镜检查的患者中，使用低剂量阿司匹林可强烈预测胃溃疡（p < 0.001）。确诊幽门螺杆菌感染患者的消化性溃疡疾病总体患病率显著高于未感染患者（p < 0.001）。在阿司匹林使用者组中，这种感染的存在与消化性溃疡疾病密切相关（p < 0.001）。多变量分析还表明，使用阿司匹林对胃肠道内镜检查后的短期死亡率有主要触发作用（p = 0.003）。
低剂量肠溶阿司匹林会导致显著的胃内镜病变，甚至可预测因胃肠道疾病进展导致的死亡率。
