老年人上消化道出血与口服NSAIDs、Hp感染相互关系的探讨

目的 探讨老年人上消化道出血与服用NSAIDs、Hp感染之间的关系。方法 采用病例对照分析的方法对146例老年上消化道出血的病例组及非上消化道出血的对照组进行胃镜检查和Hp感染检测，并统计NSAIDs服用史。结果 老年人上消化道出血者（包括胃镜疡和十二指肠溃疡）服用NSAIDs较对照组明显增加；胃溃疡病例组Hp感染明显低于对照组；而十二指肠溃疡患者，两组之间Hp感染率无明显差异，Logistic回归分析结果证明，服用NSAIDs可以增加老年人（包括胃溃疡和十二指肠溃疡）上消化道出血的危险性；Hp感染与胃溃疡所致上消化道出血的危险性呈负相关，而与十二指肠溃疡所致上消化道出血无明显关系。偶尔服用NSAIDs同样可以增加老年人上消化道出血的危险性。结论 服用NSAIDs可增加老年人上消化道出血的危险性；Hp感染可减少胃溃疡上消化道出血的危险性，而与十二指肠溃疡关系不明显。服用NSAIDs与Hp感染是老年人上消化道出血的两个独立因素。

The relationship between upper gastro-intestinal bleeding and HP infection and NSAIDs intake in the elderly patients

Objective To investigate the relationship between upper gastro intestinal bleeding and HP infection and NSAIDs intake in the elderly patients.Methods case contract study were used to analyze 146 cases of upper gastrointestinal bleeding and control of non upper gastro intestinal bleeding in old patients, using endoscopy and HP detection, as well as NSAIDs intake statistics.Results Old patients of upper gastro intestinal bleeding (including patients of gastric ulcer and duodenal ulcer) take more NSAIDs than the contrasting cases. HP infection rate of gastric ulcer is lower than the contrasting cases, while in patients of duodenal ulcer, there is no difference between the two sides. As shown in Logistic return analysis, NSAIDs intake can add the risk of upper gastro intestinal bleeding in old patients(including patients of gastric ulcer and duodenal ulcer). HP infection can diminish the risk of upper gastro intestinal bleeding in gastric ulcer patients, yet there is no relationship between HP infection and upper gastro intestinal bleeding in duodenal ulcer patients. Taking NSAIDs occasionally also adds the risk of upper gastro intestinal bleeding in old patients. Conclusions Taking NSAIDs can add the risk of upper gastro intestinal bleeding in old patients, HP infection can diminish the risk of upper gastro intestinal bleeding in gastric ulcer patients, yet there is no relationship between HP infection and upper gastro intestinal bleeding in duodenal ulcer patients. NSAIDs intake and HP infection are two independent factors in upper gastro intestinal bleeding of old patients.