口服阿司匹林致上消化道出血的危险因素分析

目的探讨口服阿司匹林致上消化道出血的相关危险因素及引起消化道大出血的相关机制。方法收集本院2010年3月至2013年4月仅口服阿司匹林一种非甾体抗炎药200例患者，用药过程中未发生消化道出血的102例患者作为对照组，引发上消化道出血的98例患者作为观察组，采集两组患者吸烟史、现病史、既往史，行凝血常规、幽门螺杆菌（Hp）检测及胃镜检查，经单因素统计分析筛选出阿司匹林引发上消化道出血的危险因素；通过多元 Logistic回归分析得出阿司匹林引发上消化道出血的独立危险因素。结果年龄＞60岁、吸烟、糖尿病、Hp感染、既往溃疡病史的患者在观察组所占比例明显高于对照组，差异具有统计学意义（P＜0.05）；经多元 Logistic回归后表明年龄＞60岁、糖尿病、Hp 感染、既往溃疡病史和阿司匹林引发上消化道出血的 OR值有统计学差异（P＜0.05）。结论年龄＞60岁、糖尿病、Hp感染、溃疡病史是阿司匹林引发上消化道出血的4个独立危险因素。

Analysis of Risk Factors of Upper Gastrointestinal Bleeding Caused by Oral Aspirin

Obj ective]To explore the correlative risk factors of upper gastrointestinal bleeding caused by oral as-pirin risk and the mechanism.Methods]A total of 200 patients only taking oral non-steroidal anti-inflammatory drugs in our hospital from March 2010 to April 2013 were collected.Among them,102 patients without upper gas-trointestinal bleeding during the medication were taken as the control group,while 9 8 patients with upper gastrointes-tinal bleeding were taken as observation group.Smoking history,present and past illness history were collected.Rou-tine coagulation,HP test and gastroscopy were performed.Univariate statistical analysis was used to screen the risk factors of upper gastrointestinal bleeding caused by aspirin.Multivariate logistic regression analysis was used to obtain the independent risk factors of upper gastrointestinal bleeding caused by aspirin.Results]The proportion of patients with the age lower than 60 years old,smoking,diabetes mellitus,HP infection and previous ulcer in observation group was obviously higher than that in control group,and there was significant difference.Multiple logistic regres-sion analysis showed that there were significant differences in the age over 60 years old,diabetes mellitus,HP infec-tion,previous ulcer and the OR value of upper gastrointestinal bleeding caused by aspirin.Conclusion]The age over 60 years old,diabetes mellitus,Hp infection and previous ulcer are the independent risk factor of upper gastrointesti-nal bleeding caused by aspirin.