药物性上消化道出血的致病药物及内镜表现

目的研究引起上消化道出血（upper gastrointestinal bleeding，UGB）的药物、胃镜表现厦特点。方法调查UGB患者的药物史和年龄，并与非药物性胃黏膜损害对照，以比较两者的胃镜表现及原有胃黏膜疾病对发病的影响。结果药物性UGB患者90倒，年龄32-87岁，以老年组（年龄≥60岁）为多65例；引起UGB的主要药物是非甾体类抗炎药（NSAIDs）；药物性UGB组幽门螺旋杆菌（Hp）的感染率低于非药物性UGB组（P〈0．01）；药物性UGB在胃镜检查中以溃疡多见（64例，71．11％），与非药物性溃疡相比溃疡偏小，呈多发性（P〈0．01）；原有消化性溃疡、残胃患者及以往有UGB者发病率高；药物性溃疡组无消化道症状者多见（P〈0．01）。结论药物性UGB以老年患者发病率高，无症状者多，引起出血的药物以NSAIDs最多见．药物性UGB镜下表现以浅表多发性小溃疡为多见，Hp感染率偏低，以往有消化性溃疡、UGB者及残胃患者更易发病。

Drugs and the endoscopic features of drug-induced upper gastrointestinal bleeding

Objective] To study drugs resulting in upper gastrointestinal bleeding (UGB) and explore the endoscopic features of drug-induced UGB. Methods] To investigate the history of drug use, age and compare the endoscopic features of gastric mucosa damage in drug-induced UGB patients with those in non-drug-induced ones. The influence of basic lesion on the on-set of advanced mucosa damage was also studied. Results] 90 drug-induced UGB patients range in age from 32 to 87 was studied, and 65 of them are above or in 60 years old. NSAIDs is the most common drug inducing UGB. As compared with the non-drug-induced UGB group, the drug-induced UGB patients have a lower infection rate of helicobacter pylori (HP), a more frequent detection of ulcers (64 cases with a rate of 71.11%), a much smaller diameter in ulcer appearance, and more in number of ulcer. Patients with peptic ulcer, remnant stomach or a history of UBG were more liable to drug-induced UGB. Few drug-induced UGB patients have gastrointestinal complaint (P <0.01). Conclusion] The elderly are more liable to drug-induced UGB, and most of them have no gastrointestinal complaint. NSAIDs is the most common drug resulting in UGB. The appearance of gastric mucosa in drug-induced UGB patients features multiple small superficial ulcers, with a lower infection rate of helicobacter pylori. Patients with a history of peptic ulcer, UBG or remnant stomach were more vulnerable to drug-induced UGB.