| Objective:To retrospectively investigate the clinical and endoseopic characteristics of non-steroidal anti-inflammatory drugs (NSAIDs) asso-ciated upper gastrointestinal bleeding.Methods:According to the information collected by 562 patientes who were suffered from upper gastrointestinal bleeding from First Affiliated Hospital of Dalian Medical University from Jan.2005 to Dec.2009. Among those cases there were 174 patients suffered from NSAIDs associated upper gastrointestinal bleeding. The basic condition, clinical manifestations, previous history, medication history and endoscopic characteristics of these patients were observed and compared with other 388 patients who suffered from upper gastrointestinal bleeding caused by ulcer disease and mucosa erosion over the same period.Results:(1)There were 1040 patients with upper gastrointestinal bleeding collected from Jan.2005 to Dec.2009.The proportion of NSAIDs associated upper gastrointestinal bleeding in recent five years respectively was: 10.92%,14.12%,16.28%,17.37%,22.69%, which increased year by year.(2)There were 55.17% of the patients over 60 years old in the NSAIDs group,which accounted for the bigger proportion than the non-NSAIDs group (p<0.05); In the NSAIDs group, there were 21.84% patients who had history of peptic ulcer and 62.07% patients who had history of cardio-cerebral-vascular diseases, which was obviously larger than the non-NSAIDs group (p<0.05); About 11.49% of patients of the NSAIDs group were alcoholics which was less than the proportion of the non-NSAIDs group (p<0.05).(3)There were 54.02% of patients in the NSAIDs group do not have any obvious symptoms before bleeding, which accounted for bigger rate (p<0.05)than the non-NSAIDs group.(4)The positive rate of two groups of Helicobacter pylori(Hp) were 63.37% and 69.33%, there were no obvious statistic differences between each other (p>0.05).(5)There were 48.85% of the patients in the NSAIDs group that the hemoglobin was less than 80g/L,this proportion was higher than non-NSAIDs group (p<0.05). However, the hemoglobin level of the former was lower than the latter(6)Acute gastric mucosal lesion was frequently observed in NSAIDs group by endoscopy (p<0.05), and gastric ulcer was more common than duodenal ulcer(p<0.05), but there were no significant differences between compound ulcer(p>0.05).(7)Treatment and prevention of cardio-cerebral-vascular diseases were most reasons of NSAIDs associated upper gastrointestinal bleeding.The most frequently used NSAIDs drug was aspirin (60.92%). Taking aspirin for example, the dosages were routine or preventive. There were 32 patients have upper gastrointestinal bleeding within one week, accounted for 18.39%; there were 84 patients have upper gastrointestinal bleeding within one month, accounted for 48.28%;and there were 58 patients have upper gastrointestinal bleeding for more than one month, accounted for 33.33%.Conclusions:(1)Incidence of NSAIDs associated upper gastrointestinal bleeding increased year by year; NSADIS was an important pathogeny of upper gastrointestinal bleeding.(2)The risk factors of NSAIDs associated upper gastrointestinal bleeding were:advanced age, history of peptic ulcer, cardio-cerebral-vascular diseases, and long-term use of drugs,etc.(3)The hidden symptoms and no obvious abdominal pain, large amount of bleeding were the clinical characteristics of NSAIDs associated upper gastrointestinal bleeding.(4)Upper gastrointestinal bleeding was frequently occured when NSAIDs was taken within one month.(5)NSAIDs and Hp infection were probably two important risk factores of peptic ulcer and ulcer bleeding.(6)The endoscopy of NSAIDs associated with upper gastrointestinal bleeding characterized by diffuse mucosal hyperemia,edema,erosion,larger. Acute gastric mucosal lesion was common. Gastric ulcer occurs in the greater curvature of gastric body,and gastric ulcer was more common than duodenal ulcer. |
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