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目的探讨肠溶阿司匹林致冠状动脉粥样硬化性心脏病(CHD)患者上消化道出血的原因。方法选取2013年1月至2014年1月广东省高州市石鼓镇中心卫生院心内科收治的250例CHD患者作为研究对象,均采用肠溶阿司匹林治疗,统计患者年龄、服用肠溶阿司匹林时长及剂量、双联抗栓(阿司匹林+氯吡格雷)、联用质子泵抑制剂(PPI)以及既往消化道病史、吸烟史等情况。结果经Logistic回归分析,高龄、大剂量、消化道病史、吸烟史均与出血明显相关;加用PPI能降低出血率。结论高龄、消化道病史及吸烟均为CHD患者产生上消化道出血的危险因素,若肠溶阿司匹林剂量≥300 mg,可考虑服用PPI。
Objective To investigate the causes of enteric-coated aspirin-induced upper gastrointestinal bleeding in patients with coronary atherosclerotic heart disease (CHD). Methods From January 2013 to January 2014, 250 CHD patients admitted to Department of Cardiology, Shigu Hospital, Gaozhou City, Guangdong Province were enrolled in this study. All patients were enrolled in this study. The patients were treated with enteric-coated aspirin. The patients’ age, duration of taking aspirin, Dose, double antithrombotic (aspirin + clopidogrel), combined with proton pump inhibitor (PPI), as well as previous gastrointestinal history, smoking history and so on. Results Logistic regression analysis showed that age, high dose, history of gastrointestinal tract and smoking history were significantly correlated with hemorrhage. Adding PPI could reduce the bleeding rate. Conclusion The elderly, gastrointestinal history and smoking are the risk factors of upper gastrointestinal bleeding in patients with CHD. If the dosage of aspirin ≥ 300 mg, PPI may be considered.