非甾体抗炎药相关性上消化道出血临床特点

目的探讨非甾体抗炎药(NSAIDs)所致上消化道出血的临床特点。方法选择2002年1月-2004年12月因上消化道出血在本院行胃镜检查的378例患者，分为服用NASIDs组(观察组)和未服用NSAIDs组(对照组)，比较两组患者内镜下病变特点及幽门螺杆菌(HP)感染情况，结果378例患者中，服用NASIDs67例，占17．7%，未服药组311例，占82．3％；观察组老年人明显高于对照组，发生胃渍疡和复合渍疡几率明显高于对照组；观察组HP阳性患者胃黏膜充血、水肿及多发糜烂发生率显著高于无HP感染者，结论NSAIDs所致上消化道出血的主要临床特点为：常见于老年人，内镜下胃渍疡和复合溃疡多见，HP感染增加发生胃黏膜糜烂的机会．

Clinical Analysis of Upper Gastrointestinal Hemorrhage Caused by Non- steroidal Anti- inflammatory Drugs

Objective To study the clinical characteristics of upper gastrointestinal hemorrhage caused by non-steroidal anti-inflammatory drugs (NSAIDs). Methods The 378 patients presenting with upper gastrointestinal hemorrhage and receiving gastroscopy during the period of Jan,2002~Dec, 2004 were divided into two groups according to with or without intake of NSAIDs. We evaluated the clinical and endoscopic manifestations and the frequency of Helicobacter pylori(HP) infection between the two groups. Results Among 378 patients, 67 cases(17.7%) were NSAIDs group and 311 cases(82.3%) were non-NSAIDs group. More elder patients and higher frequency of gastric ulcer or compound ulcer were found in NSAIDs group than in non-NSAIDs group . By endoscopy, disseminated hyperemia, edema and multiple erosion in gastric mucosa had more frequency in HP infection than non-HP infection in NSAIDs group. Conclusion The main clinical and endoscopic manifestations of upper gastrointestinal hemorrhage caused by NSAIDs are easy to find in elderly patients and have a higher frequency of gastric ulcer and compound ulcer. HP infection increases gastric erosion.