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目的探讨抗凝及抗血小板药物导致消化道出血的临床特点和影响因素。方法回顾我院自2008年2月至2011年3月收治的62例急性冠脉综合征(ACS)老年患者资料,随机分为对照组和观察组,每组31例。对照组采用抗血小板药物治疗,观察组在对照组的基础上加用质子泵抑制剂(PPI),观察两组接受治疗后上消化道大出血时的临床特征并分析原因及影响因素。结果随访6个月,对照组出现上消化道出血患者共8例,占25.81%;观察组出现2例,占6.45%。两组比较差异有统计学意义(P<0.05)。结论采用抗血小板及抗凝药物治疗的患者多出现胃溃疡及血红蛋白下降,胃黏膜萎缩等症状,且易感染幽门螺杆菌。老年患者比中青年患者更易发生消化道出血,非甾体抗炎类药物用量过大是引发消化道出血的主要原因。
Objective To investigate the clinical characteristics and influencing factors of gastrointestinal bleeding caused by anticoagulant and antiplatelet drugs. Methods The data of 62 elderly patients with acute coronary syndrome (ACS) admitted to our hospital from February 2008 to March 2011 were randomly divided into control group and observation group, with 31 cases in each group. The control group was treated with antiplatelet drugs. The observation group was given proton pump inhibitor (PPI) on the basis of the control group. The clinical features of upper gastrointestinal bleeding after treatment were observed and the causes and influencing factors were analyzed. Results All the patients were followed up for 6 months. There were 8 cases of upper gastrointestinal bleeding in the control group (25.81%), and 2 cases (6.45%) in the observation group. The difference between the two groups was statistically significant (P <0.05). Conclusions Patients treated with anti-platelet and anticoagulant drug often have gastric ulcer, decreased hemoglobin and gastric mucosal atrophy, and are susceptible to Helicobacter pylori infection. Geriatric patients are more prone to gastrointestinal bleeding than middle-aged patients, non-steroidal anti-inflammatory drugs in excessive amounts is the main cause of gastrointestinal bleeding.