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幽门螺杆菌与非甾体抗炎药引发胃溃疡的内镜特征分析 被引量:14

Clinic observation on endoscopic features of Helicobacter Pylori-infection and nonsteroidal anti-inflammatory drugs associated gastric ulcers
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摘要 目的:了解幽门螺杆菌感染患者服用不同的非甾体类抗炎药(NSAIDs)后发生胃溃疡的内镜特征。方法:对379例处于活动期胃溃疡的患者进行了研究,患者分为3组:(1)未使用布洛芬(IBF)和LDA(小剂量阿司匹林)的幽门螺杆菌-阳性患者(对照组,n=216);(2)使用布洛芬的幽门螺杆菌-阳性或阴性患者(IBF组,n=100);(3)使用LDA的幽门螺杆菌-阳性或阴性患者(LDA组,n=63)。观察了3组患者在内镜下的溃疡特征(部位、多样性和形态)。结果:在IBF组,无论有无幽门螺杆菌感染,都具有较高发生的胃窦部不规则溃疡的发生率。LDA组在幽门螺杆菌阴性患者中,具有较高的胃窦溃疡发生率,而且无论有无幽门螺杆菌感染,都具有较高的多重溃疡发生率。LDA组不规则形状溃疡的发生率则与对照组没有差异。结论:由IBF诱发的溃疡经常发生在胃下部(胃窦),常表现为不规则的形状。而LDA引发的溃疡则具有较高的多重溃疡发生率。研究对于根据溃疡的形态内镜特征推理溃疡发生的主要原因具有重要临床意义。 OBJECTIVE To evaluate the endoscopic characteristics of gastric ulcers in patients who were using non-steroidal anti-inflammatory drugs (NSAIDs) and were infected with Helicobacter pylori remain. METHODS A total of 379 patients with active-stage gastric ulcer were divided into three groups: H. pylori-positive patients using neither ibuprofen nor LDA (con- trol group,n = 216), H. pylori-positive or-negative patients using ibuprofen(IBF group,n = 100), and H. pylori-positive or - negative patients using LDA (LDA group, n = 63). The differences among these groups in endoscopic characteristics of the ul- cers (site,multiplicity,and morphology) were determined. The influence of an antacid drug, i. e. , a proton pump inhibitor (PPI) or a histamine H2 receptor antagonist (H2RA), was also investigated. RESULTS The Ibuprofen group, regardless of H. pylori infection status, had higher incidences of antral, multiple, and irregularly shaped ulcers. The LDA group had a higher incidence of antral ulcers in H. pylori-negative patients and,regardless of H. pylori infection status,a higher incidence of multiple ulcers. However,the incidence of irregularly shaped ulcers in the LDA group did not differ from that in the control group. Neither the concomitant use of an antacid nor the dosing period of ibuprofen affected the results. CONCLUSION The ulcer induced by IBF occurs frequently in the lower part of the stomach ( gastric antrum ), manifesting as irregular shape while multiple ulcer is often induced by LDA. The main reason for morphological endoscopic feature inference ulcer ulcer has impor- tant clinical significance.
出处 《中国医院药学杂志》 CAS CSCD 北大核心 2013年第11期886-890,共5页 Chinese Journal of Hospital Pharmacy
关键词 胃溃疡 幽门螺杆菌 非甾体抗炎药 gastric ulcer Helicobacter pylori non-steroidal anti-inflammatory drug
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参考文献12

  • 1Asaka M, Kato M, Sugiyama T, etal. Follow-up survey of a large-scale multicenter, double-blind study of triple therapy with lansoprazole, amoxicillin, and clarithromycin for eradica- tion of Helicohacter pylori in Japanese peptic ulcer patients [J]. J Gastroenterol,2009,38(3) :339-347.
  • 2Ford AC, Delaney B, Forman D,et al. Eradication therapy for peptic ulcer disease in Helicobacter pylori positive patients[J]. Cochrane Database Syst Rev, 2009, (2) : CD003840.
  • 3Huang JQ, Sridhar S, Hunt RH. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic- ulcer disease: a meta-analysis[J]. Lancet, 2010,359(43): 14- 22.
  • 4Hart J, Hawkey CJ, Lanas A, et al. 1. Predictors of gastrodn odenal erosions in patients taking low- dose aspirin[J]. Ali- ment Pharmacol Ther, 2010,31 (1) : 143-149.
  • 5Kamada T, Hata J, Kusunoki H, etal. Eradication of Helico- bacter pylori increases the incidence of hyperlipidaemia and o- besity in peptic ulcer patients[J]. Dig Liver Dis,2011,37(4): 39-43.
  • 6Niv Y, Battier A, Abuksis O, et al. Endoscopy in asympto- matic minidose aspirin consumers [J ]. Dig Dis Sci, 2(110, 50(21) : 78-80.
  • 7Graham DY, Opekun AR, Willingham FF, et al. Visible small-intestinal mucosal injury in chronic NSAID users [J]. Clin Gastroenterol Hepatol,2009,3( 1 ) : 55 -59.
  • 8Lanas A, Garc a-Rodr guez LA, Arroyo MT, et al. Risk of upper gastrointestinal ulcer bleeding associated with selective cyclo oxygenase-2 inhibitors, traditional non-aspirin non-ster oidal anti-inflammatory drugs, aspirin and eombinations[J]. Gut, 2009,55(11) : 1731-1738.
  • 9Kamada T, Hata J, Kusunoki H, et al. Endoscopic character- istics and Helicobacter pylori infection in NSAII>associated gastric ulcer[J]. J Gastroenterol Hepatol, 2006,21 ( 1 Pt 1 ) : 98- 102.
  • 10Kato S, Matsukura N, Tsukada K, et al. Helicobacter pylori infection negative gastric cancer in Japanese hospital patients: incidence and pathological characteristics [J].Cancer Sci, 201 1,98 (26) :790-794.

同被引文献104

  • 1邹华.埃索美拉唑与奥美拉唑治疗胃溃疡的药物经济学研究[J].医学信息(医学与计算机应用),2016,29(34):295-295. 被引量:4
  • 2薛国丹.幽门螺杆菌与非甾体抗炎药引发胃溃疡的内镜特征分析[J].医学信息(医学与计算机应用),2014,0(21):402-402. 被引量:1
  • 3侯晓华,蔺蓉.胃黏膜保护与胃动力[J].中华医学杂志,2005,85(39):2739-2741. 被引量:13
  • 4李岩.消化性溃疡的药物治疗进展[J].中国实用内科杂志,2007,27(1):24-25. 被引量:103
  • 5TargownikL E,Nabalamba A.Trends in management and outcomes of acute nonvariceal upper gastrointestinal bleeding:1993-2003[J].Clin Gastroenterol Hepatol,2006,4{12): 1459-1466.
  • 6Salehimarzijarani B,Mousavi M,Dadvar Z,et a . Relationship between continuous use of low- dose enteric-coated aspirin and gastrointestinal injuries in patients with gastrointestinal hemorrhage[J]. Turk J Gastroenterol, 2013,24(2) :93-98.
  • 7Deeks ED.Fixed-Dose Ibuprofen/Famotidine:A Review of Its Use to Reduce the Risk of Gastric and Duodenal Ulcers in Patients Requirhng NSAID Therapy[J]. Clin Drug Investig, 2013,33(9): 689-697.
  • 8TYamaguchi Y,YamatoT,KatsumiN,et al. Endoscopic hemostasis:safe treatment for peptic ulcer patients aged 80 years or older[J].J Gastroenterol Hepat ol, 2003,18(5): 521-525.
  • 9Fashner J,Gitu AC.Diagnosis and treatment of peptic ulcer disease and H.pylori infection[J].Am Fam Physician,2015,91(4):236-242.
  • 10Reva IV,Yamamoto T,Vershinina SS,et al.Immune homeostasis of human gastric mucosa in Helicobacter pylori infection[J].Bull Exp Biol Med,2015,159(1):157-163.

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