Department of Geriatrics, First Hospital of Lanzhou University, Lanzhou, 730000, China.
The First School of Clinical Medicine of Lanzhou University, Lanzhou, 730000, China.
Sci Rep. 2024 Sep 27;14(1):22084. doi: 10.1038/s41598-024-73661-9.
To investigate the relationship between long-term use of low-dose aspirin and Helicobacter pylori (HP) infection, and its effect on eradication and recurrence of HP. According to the results of C-Urea Breath Test (C-UBT), 3256 patients with cardiovascular and cerebrovascular diseases from March 2019 to December 2020, were divided into HP infection group and non-infection group. Univariate and multivariate was used to investigate the relationship between Low-dose aspirin use and HP infection. 859 patients with hypertension combined with HP infection were divided into aspirin group, non-aspirin group and control group, the eradication rate after 2 weeks of bismuth-containing quadruple drug treatment and the recurrence rate after 1,3 year were compared. The overall infection rate of HP was 53.3%. The results of univariate analysis showed that the infection rate of female, age, BMI, LDL-C, FBG of HP infected group was higher than non-infection. The infection rate of patients who took low-dose aspirin was higher than no-aspirin [56.6% vs. 51.3%, χ = 8.548, P = 0.003]. Multivariate Logistic regression analysis showed that long-term aspirin use still increased the risk of infection (OR = 1.433, 95% CI 1.196-1.947, P < 0.001). The Per-Protocol analysis showed that the overall eradication rate was 87.6%, and among the eradication rates of aspirin group, non-aspirin group and control group were not statistically significantly (87.8%, 88.5%, and 86.6%, respectively), The Intention-To-Treat analysis showed that the overall eradication rate was 84.3%, and the eradication rates among the three groups were not statistically significantly. The overall 1-year recurrence rate was 1.3%, and the recurrence rates of the three groups were no statistical significance. The overall 3-years recurrence rate was 3.1%, and the recurrence rate of aspirin group was higher than non-aspirin group and control group (5.30%, 1.90% and 1.70%, respectively, χ = 6.118, P < 0.05). The main adverse reactions in the first month of eradication treatment were constipation and mild nausea, and there was no statistical significance between the three groups. Long-term use of low-dose aspirin increases the risk of HP infection and the recurrence rate in 3 years after eradication. It is suggested that HP should be tested and eradicated regularly in long-term users.
为了探讨长期低剂量使用阿司匹林与幽门螺杆菌（HP）感染之间的关系及其对 HP 根除和复发的影响。根据 C-尿素呼气试验（C-UBT）的结果，将 2019 年 3 月至 2020 年 12 月间的 3256 例心血管疾病患者分为 HP 感染组和非感染组。采用单因素和多因素分析探讨低剂量阿司匹林使用与 HP 感染的关系。将 859 例高血压合并 HP 感染的患者分为阿司匹林组、非阿司匹林组和对照组，比较铋四联药物治疗 2 周后的根除率和 1、3 年后的复发率。HP 的总感染率为 53.3%。单因素分析结果显示，HP 感染组女性、年龄、BMI、LDL-C、FBG 高于非感染组，长期服用低剂量阿司匹林的患者感染率高于未服用者[56.6%比 51.3%，χ=8.548，P=0.003]。多因素 Logistic 回归分析显示，长期使用阿司匹林仍会增加感染风险（OR=1.433，95%CI 1.196-1.947，P<0.001）。按方案分析显示，总体根除率为 87.6%，阿司匹林组、非阿司匹林组和对照组的根除率分别为 87.8%、88.5%和 86.6%，差异无统计学意义；意向治疗分析显示，总体根除率为 84.3%，三组间差异无统计学意义。总体 1 年复发率为 1.3%，三组间差异无统计学意义。总体 3 年复发率为 3.1%，阿司匹林组的复发率高于非阿司匹林组和对照组（分别为 5.30%、1.90%和 1.70%，χ=6.118，P<0.05）。根除治疗第 1 个月的主要不良反应为便秘和轻度恶心，三组间差异无统计学意义。长期低剂量使用阿司匹林会增加 HP 感染的风险，并在根除后 3 年内增加复发率。建议长期使用者定期检测和根除 HP。
