非甾体类抗炎剂致上消化道溃疡的临床特点

[目的]研究非甾体类抗炎剂（NSAIDs）相关胃、十二指肠溃疡的临床特点。[方法]统计2001年1月～2006年1月消化病专家门诊及住院患者的临床资料。根据胃镜检查前1周内有无服用NSAIDs史，将138例患者分为A（服NSAIDs，41例）、B（未服NSAIDs，97例）组，对2组患者的临床症状、胃镜、活检结果进行比较。[结果]饱胀、烧心、恶心、腹痛4项主症中前3项A组均高于B组，但腹痛B组高于A组（P〈0．05）。A组中胃溃疡（GID占80．5％（多发性为24．4％），十二指肠球部溃疡（DID为19．5％（多发性4．9％）；B组分别为48．5％（12．4％）、51．5％（11．3％）。活动性溃疡A组占63．4％，溃疡灶〈10mm占80．5％；B组分别为42．3％、62．9％，2组间比较P〈0．01。幽门螺杆菌检出率A组63．4％，B组81．3％，B组明显高于A组（P〈0．05）。[结论]提高临床医师对NSAIDs相关溃疡临床特点的认识，加强对必须服用NSAIDs者的防治及医学指导，尽量减少其不良反应。

Clinical characteristics of non-steroidal anti-inflammatory drugs related peptic ulcer

[Objective]To investigate the clinical characteristics of non-steroidal anti-inflammatory drugs(NSAIDs) related gastric and duodenal ulcer.[Methods] Clinical data of patients from Jan.2001 to Jan.2006 were collected.One hundred and thirty-eight patients were divided into two groups(A and B) according to the history of taking NSAIDs in one week before endoscopy.The symptoms and biopsy results between two groups were compared.[Results] There were forty-one patients with the history of taking NSAIDs(group A) and ninety-seven patients without the above history(group B).The average age in group A was 56.2 ys and patients' age older than 60 ys held 39.1 %,while those in group B were 41.6 ys and 12.4 % respectively,which had significant difference with group A(P<0.05).Patients with fullness,heartbum and nausea in group A were more than group B,while those with abdominal pain in group B were more than group A(P<0.05).The morbidity of gastric ulcer(GU) in group A was 80.5%(multiple 24.4 %) and duodenal ulcer(DU) was19.5 %(multiple 4.9 %),while those in group B was 48.5%(multiple 12.4%) and 51.5%(multiple 11.3%).Meanwhile,the percentage of active ulcer in group A was 63.4% and the ulcer with the diameter smaller than one centimeter was 80.5%,while those in group B was 42.3% and 62.9%,which had significant difference with group A(P<0.01).Helicobacter pylori(Hp) positive rate in group B was obviously higher(81.3%) than that of group A(63.4%)(P<0.05).[Conclusion] Physicians should be cautious to NSAIDs related peptic ulcer and strengthen the medical guidance of patients taking NSAIDs.More attention should be paid to prevent and reduce the side effect of NSAIDs.