Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo 113-8421, Japan.
Gastroenterol Res Pract. 2015;2015:252963. doi: 10.1155/2015/252963. Epub 2015 Jan 26.
Background. We investigated the prevalence, symptoms, and QOL impact of esophageal (EI), gastric (GI), and duodenal mucosal injury (DI) individually between low-dose aspirin (LDA) users and nonusers to reveal the clinical features of LDA-related mucosal injury. Methods. Data were extracted from the records of subjects who underwent upper gastrointestinal endoscopy at our department between April 2008 and December 2013. Responses from 3162 elderly patients on Frequency Scale for Symptoms of GERD (FSSG) and SF-8 QOL questionnaires (SF-8) were analyzed. FSSG items were classified into total score (TS), reflux score (RS), and dyspepsia score (DS). The SF-8 questionnaire consisted of the physical component summary (PCS) and mental component summary (MCS). Results. Prevalence among LDA users and nonusers, respectively, was 9.6% and 10.0% (P = 0.83) for EI, 35.9% and 27.5% (P = 0.0027) for GI, 3.3% and 3.4% (P = 0.84) for DI, and 8.2% and 5.2% (P = 0.036) for mucosal injury in 2 or more organs. LDA users diagnosed with EI had significantly lower PCS, LDA users diagnosed with GI had significantly lower DS, and LDA users diagnosed with DI had significantly lower RS and significantly lower MCS. Conclusion. These results provide important clinical information indicating that symptom-based management is not appropriate in LDA users regarding upper gastrointestinal mucosal injury.
背景。我们调查了低剂量阿司匹林（LDA）使用者和非使用者中食管（EI）、胃（GI）和十二指肠黏膜损伤（DI）的患病率、症状和生活质量（QOL）影响，以揭示 LDA 相关黏膜损伤的临床特征。方法。从 2008 年 4 月至 2013 年 12 月在我院行上消化道内镜检查的患者记录中提取数据。分析了 3162 名老年患者对反流症状频率量表（FSSG）和 SF-8 生活质量问卷（SF-8）的回答。FSSG 项目分为总分（TS）、反流评分（RS）和消化不良评分（DS）。SF-8 问卷包括生理成分综合评分（PCS）和心理成分综合评分（MCS）。结果。LDA 使用者和非使用者分别为 EI 的 9.6%和 10.0%（P=0.83）、GI 的 35.9%和 27.5%（P=0.0027）、DI 的 3.3%和 3.4%（P=0.84）和 2 个或多个器官黏膜损伤的 8.2%和 5.2%（P=0.036）。诊断为 EI 的 LDA 使用者的 PCS 显著降低，诊断为 GI 的 LDA 使用者的 DS 显著降低，诊断为 DI 的 LDA 使用者的 RS 和 MCS 显著降低。结论。这些结果提供了重要的临床信息，表明对于上消化道黏膜损伤，基于症状的管理不适用于 LDA 使用者。
