Sogabe Masahiro, Okahisa Toshiya, Nakasono Masahiko, Fujino Yasuteru, Mitsui Yasuhiro, Takaoka Yoshihumi, Kimura Tetsuo, Okamoto Koichi, Muguruma Naoki, Takayama Tetsuji
From the Department of General Medicine and Community Health Science, Institute of Health, Biosciences, Tokushima University Graduate School (MS, TO); Department of Gastroenterology and Oncology, Institute of Health Biosciences, Tokushima University Graduate School, Tokushima (MS, TO, YF, YM, YT, TK, KO, NM, TT); Department of Gastroenterology, Kagawa Prefectural Cancer Detection Center, Takamatsu, Japan (MS); Department of Internal Medicine, Tsurugi Municipal Handa Hospital, Tokushima, Japan (MN).
Medicine (Baltimore). 2015 Jul;94(26):e1047. doi: 10.1097/MD.0000000000001047.
Antiplatelet drugs are widely used for the prevention of cardiovascular disease and cerebral vascular disorders. Although there have been several studies on gastroduodenal mucosal injury with gastrointestinal (GI) symptoms such as GI bleeding, in antiplatelet drug users (including low-dose aspirin (LDA)), there have been few reports on the association between antiplatelet drug use and gastroduodenal mucosal injury in asymptomatic antiplatelet drug users. This study was a cross-sectional study elucidating the association between antiplatelet drug use and gastroduodenal mucosal injury in asymptomatic antiplatelet drug users.Subjects were 186 asymptomatic Japanese antiplatelet drug users who underwent a regular health checkup. Subjects were divided into those with and without gastroduodenal mucosal injury endoscopically, and the association between gastroduodenal mucosal injury and other data in asymptomatic antiplatelet drug users was investigated.The prevalence of males and drinkers were significantly higher in subjects with gastroduodenal mucosal injury than in those without. In addition, the prevalence of proton pump inhibitor (PPI) users was significantly lower in subjects with gastroduodenal mucosal injury than in subjects without gastroduodenal mucosal injury. Logistic regression analysis showed PPI (odds ratios: 0.116; 95% confidence intervals: 0.021-0.638; P < 0.05) was a significant predictor of a decreased prevalence of gastroduodenal mucosal injury and closed-type (C-type) atrophy (3.172; 1.322-7.609; P < 0.01) was a significant predictor of an increased prevalence of severe gastroduodenal mucosal injury in asymptomatic antiplatelet drug users.Gender and lifestyle, such as drinking, may have an impact on risk of gastroduodenal mucosal injury in asymptomatic subjects taking antiplatelet drugs. Although PPI is a significant predictor of a decreased prevalence of gastroduodenal mucosal injury, including in asymptomatic antiplatelet drug users, status of gastric atrophy should also be considered against severe gastroduodenal mucosal injury.
抗血小板药物广泛用于预防心血管疾病和脑血管疾病。尽管已有多项关于抗血小板药物使用者（包括低剂量阿司匹林（LDA）使用者）出现胃肠道（GI）症状如GI出血导致胃十二指肠黏膜损伤的研究，但关于无症状抗血小板药物使用者中抗血小板药物使用与胃十二指肠黏膜损伤之间的关联报道较少。本研究是一项横断面研究，旨在阐明无症状抗血小板药物使用者中抗血小板药物使用与胃十二指肠黏膜损伤之间的关联。研究对象为186名接受定期健康检查的无症状日本抗血小板药物使用者。根据内镜检查结果将研究对象分为有胃十二指肠黏膜损伤组和无胃十二指肠黏膜损伤组，并调查无症状抗血小板药物使用者中胃十二指肠黏膜损伤与其他数据之间的关联。胃十二指肠黏膜损伤组男性和饮酒者的患病率显著高于无损伤组。此外，胃十二指肠黏膜损伤组质子泵抑制剂（PPI）使用者的患病率显著低于无胃十二指肠黏膜损伤组。逻辑回归分析显示，PPI（比值比：0.116；95%置信区间：0.021 - 0.638；P < 0.05）是无症状抗血小板药物使用者胃十二指肠黏膜损伤患病率降低的显著预测因素，而闭合型（C型）萎缩（3.172；1.322 - 7.609；P < 0.01）是无症状抗血小板药物使用者严重胃十二指肠黏膜损伤患病率增加的显著预测因素。性别和生活方式，如饮酒，可能对服用抗血小板药物的无症状受试者胃十二指肠黏膜损伤风险有影响。尽管PPI是胃十二指肠黏膜损伤患病率降低的显著预测因素，包括在无症状抗血小板药物使用者中，但对于严重胃十二指肠黏膜损伤，也应考虑胃萎缩状态。
