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目的 通过内镜观察探讨胃肠黏膜损伤与非甾体抗炎药 (NSAIDs)的关系。方法 连续观察了 2 0 0例内镜下胃肠黏膜损伤病例。根据是否服用NSAIDs药物将患者分为NSAIDs组 (Ⅰ组 )及非NSAIDs组 (Ⅱ组 )。结果 Ⅰ、Ⅱ组患者分别占 4 6 5 %及 5 3 5 % (P >0 0 5 )。与Ⅱ组比较 ,Ⅰ组中 >6 0岁者占 81 7% (P <0 0 0 1) ,无症状者占 5 8 8% (P <0 0 5 ) ,患心血管疾病者占 70 6 % (P <0 0 5 ) ,胃溃疡占 5 0 0 % (P <0 0 5 ) ,溃疡并发出血占 11 8% (P <0 0 1)。Ⅰ组合并上消化道出血的相对危险是Ⅱ组的 7 0 4倍 (χ2 =6 2 17,P <0 0 5 )。结论 NSAIDs相关性胃肠黏膜损伤具有较为特异的临床及胃镜下表现 ,其合并上消化道出血的危险性较高 ,应引起重视。
Objective To investigate the relationship between gastrointestinal mucosal injury and non-steroidal anti-inflammatory drugs (NSAIDs) by endoscopic observation. Methods 200 consecutive cases of gastrointestinal mucosal injury under endoscopy were observed. Patients were divided into NSAIDs group (group I) and non-NSAIDs group (group II) depending on whether they took NSAIDs or not. Results Patients in group Ⅰ and Ⅱ accounted for 46.5% and 53.5% respectively (P> 0.05). Compared with group Ⅱ, 81.7% of patients in group Ⅰ (P <0.01), 58.8% of patients in asymptomatic group (P <0.05), 70% of patients in cardiovascular group % (P <0.05). Gastric ulcer accounted for 500% (P <0.05), and ulcerated bleeding accounted for 11.8% (P <0.01). The relative risk of combination Ⅰ with upper gastrointestinal bleeding was 704 times higher than that of group Ⅱ (χ2 = 6217, P <0 05). Conclusion NSAIDs-related gastrointestinal mucosal injury has a more specific clinical and endoscopic findings. The risk of upper gastrointestinal bleeding is high, which should be paid more attention to.