阿司匹林肠溶片治疗老年冠心病患者引起上消化道出血的影响因素分析

目的:探讨阿司匹林肠溶片治疗老年冠心病患者引起上消化道出血的影响因素。方法:对2010年10月-2013年10月我院接诊的214例口服阿司匹林肠溶片的老年冠心病患者进行回顾性分析,对51例发生上消化道出血的患者的原因进行分析,内容包括:性别、年龄、服药时间和剂量、既往消化道病史、吸烟史及联用胃黏膜保护剂等情况。结果:随着患者年龄增长,上消化道出血率显著升高(=11.526,P<0.01);服药超过3个月的患者出血发生率显著高于服药低于3个月的患者(=8.530,P<0.01),差异有统计学显著意义;大剂量组出血发生率显著高于小剂量组(=5.127,P<0.01),差异有统计学意义;性别与上消化道出血的发生无相关性(P>0.05),有吸烟史或消化道病史的患者服用阿司匹林肠溶片后更易导致上消化道出血(P均<0.05),而服用阿司匹林肠溶片同时服用胃黏膜保护剂的患者上消化道出血的发生率显著低于未服用胃黏膜保护剂的患者(P<0.05)。结论:有消化道病史、高龄、大剂量、服药时间、有吸烟史、不用胃黏膜保护剂是上消化道出血的独立的危险因素,使用阿司匹林肠溶片治疗的同时,应注意及时给予胃黏膜保护药,以期减少上消化道出血的危害性。

Analysis on the Influencing Factors of Upper Gastrointestinal Bleeding Caused by Aspirin Enteric-coated Tablets in Elderly Patients with Coronary Heart Disease

Objective：To explore the inlfuencing factors of upper gastrointestinal bleeding caused by aspirin enteric-coated tablets in elderly patients with coronary heart disease （CHD）. Methods： 214 cases of elderly patients with coronary heart disease oral y taking aspirin enteric-coated tablets in our hospital from October 2010 to October 2013 were retrospectively analyzed, including gender, age, administration time and dosage, past history of digestive tract diseases, smoking history, and combination of gastric mucosa protectant etc. Results：Along with increased ages of patients, the incidence of upper gastrointestinal hemorrhage rise signiifcantly （ x^2=11.526, P〈0.01）; the incidence of bleeding in patients taking aspirin for more than 3 months was statistical ysigniifcantly higher than those taking aspirin for less than 3 months （x^2 =8.530, P〈0.01）; the incidence of upper gastrointestinal hemorrhage in high-dose group was statistical y signiifcantly higher than low-dose group （ x^2=5.127, P〈0.01）;no correlation between gender and upper gastrointestinal hemorrhage was found （P〉0.05）; more events of upper gastrointestinal hemorrhage occurred in patients with smoking history or history of digestive diseases when taking aspirin （P〈0.05）. And the incidence of gastrointestinal hemorrhage in patients who taking both aspirin enteric-coated tablets and gastric mucosa protectant was signiifcantly lower than those who didn’t take gastric mucosa protectant （P〈0.05）. Conclusion：A history of digestive tract disease, older age, large doses, administration time, smoking history, without gastric mucosa protectant are independent risk factors for upper gastrointestinal bleeding.Gastric mucosa protectant should be given when using aspirin enteric-coated tablets for treatment at the same time, in order to reduce the dangers of upper gastrointestinal bleeding.