[阿司匹林所致胃十二指肠黏膜损伤。风险处理]

[Gastroduodenal mucosal injuries by aspirine. Management of the risks].

作者信息

Martínez M Julián David, Molano V Juan Carlos, Henao R Sandra Consuelo

机构信息

Facultad de Medicina, Universidad Nacional de Colombia, Bogotá D.C., Colombia; Centro médico Endocentrolimitada. Bogotá D.C, Colombia.

Centro médico Endocentrolimitada. Bogotá D.C, Colombia.

出版信息

Rev Gastroenterol Peru. 2016 Apr-Jun;36(2):129-34.

PMID:27409089

Abstract

BACKGROUND

Aspirin is one of the most used drugs around the Word, it has wide therapeutic indications. From its original indications, as analgesic and anti-inflammatory and due to its platelet antiaggregate properties, this drug has become in the most employed medicine to prevent cardiovascular disease. Never the less, it is a drug with adverse effects and gastrointestinal toxicity indeed.

OBJECTIVES

To identify the reasons of using aspirin, endoscopic findings on gastropathy caused by ASA and the relative risk of developing mucosal lesions. This based on a sample of adult patients in a chosen particular institution.

MATERIALS AND METHODS

Prospective study of cases and controls, from January 1 to June 31, 2014, with patients with high digestive endoscopy. In the medical center Endocentro Bogotá D.C. it was selected the people with aspirin consumption on 500 mg per day dose or less taken for more than six months prior the endoscopy.

RESULTS

We selected 602 patients, 534 (88%) were women and 168 (12%) were men, with an age range from 17 to 92 years and with an average of 51.8 years. 107 patients were the aspirin users, 59 (55%) were women and 48 (45%) were men, with an range from 23 to 85 years and with an average of 58 years. The follow relative risks were found: gastroduodenal erosions RR=4.9 (95%IC 3.87-8.37), gastric ulcer RR=2.4 (95%IC 1.3-9.0), duodenal ulcer RR=2.8 (95%IC 1.3-7.0) any kind of gastrointestinal injury RR=5.5 (95%IC 4.1-7.2) aspirin users without any indication to the risk of develop any mucosa injury RR=2.0 (95%IC 1.4-3.0).

CONCLUSIONS

This study showed an important proportion (18%) of dispatched aspirin users adults to digestive endoscopy, the 13.8% of them have a clear indication to use it, a substantial percent (13%) cannot inform any medical reason; the aspirin usage for more than six months in doses lower than 500 mg per day increases the mucosal gastroduodenal injury prevalence (58%)and relative risk of suffering these injuries are high.

摘要

背景

阿司匹林是全球使用最广泛的药物之一，具有广泛的治疗适应症。从其最初作为止痛、抗炎药物，到因其血小板抗聚集特性，该药物已成为预防心血管疾病最常用的药物。然而，它确实是一种有副作用和胃肠道毒性的药物。

目的

确定使用阿司匹林的原因、阿司匹林所致胃病的内镜检查结果以及发生黏膜病变的相对风险。这基于在一个特定机构中选取的成年患者样本。

材料与方法

对2014年1月1日至6月31日接受高分辨率消化内镜检查的患者进行病例对照前瞻性研究。在波哥大特区的Endocentro医疗中心，选取在内镜检查前六个月以上每天服用500毫克及以下剂量阿司匹林的患者。

结果

我们选取了602例患者，其中534例（88%）为女性，168例（12%）为男性，年龄范围为17至92岁，平均年龄为51.岁。107例患者为阿司匹林使用者，其中59例（55%）为女性，48例（45%）为男性，年龄范围为23至85岁，平均年龄为岁。发现以下相对风险：胃十二指肠糜烂RR = 4.9（95%置信区间3.87 - 8.37），胃溃疡RR = 2.4（95%置信区间1.3 - 9.0），十二指肠溃疡RR = 2.8（95%置信区间1.3 - 7.0），任何类型的胃肠道损伤RR = 5.5（95%置信区间4.1 - 7.2），无任何黏膜损伤风险指征的阿司匹林使用者RR = 2.0（95%置信区间1.4 - 3.0）。