Clinical Characteristics Analysis Of Non-steroidal Anti-inflammatory Drugs Associated Upper Gastrointestinal Bleeding.

Objective To evaluate the clinical characteristics of non-steroidal anti-inflammatory drugs(NSAIDs) associated upper gastrointestinal bleeding.Methods Clinical dates with upper gastrointestinal bleeding from June 2007 to June 2009 were collected from Fujian Medical University Union Hospital. Patients were divided into two groups based on whether consumed NSAIDs 10 days previous to the onset of bleeding. The type,usage duration and the reasons of NSAIDs were also analyzed in NSAIDs group. Age,gender,history of peptic ulcer,upper gastrointestinal bleeding and cardio-cerebral-vascular disease,clinical characteristics,hemoglobin level,length of stay,endoscopic characteristics and Helicobacter pylori(HP) infection were analyzed between the tow group.Results Clinical dates of 374 patients with upper gastrointestinal bleeding were collected .80(21.4%) patients consumed NSAIDs 10 days before bleeding. In NSAIDs group,the most frequently used NSAIDs drug was aspirin(42.6%),while acetaminophen and diclofenac were often used, too. Patients taken NSAIDs for less than 10 days and more than 1 year,occupied 37.5%,40% .43.8% in NSAIDs group applied to cardio-cerebral-vascular disease,others to arthralgia caused by rheumatoid arthritis,gout etc and respiratory infection. NSAIDs group were older than control group, there were more elders(≥60 years), while control group were more yours(≤40 years) (P<0.05); NSAIDs group were more likely to have a history of smoking,cardio-cerebral-vascular disease(P<0.05), but, less likely to have a history of peptic ulcer,upper gastrointestinal bleeding (P<0.05).Gastrointestinal symptoms were not distinct before bleeding in NSAIDs group (P <0.05).There were more gastric ulcer and acute gastric mucosal lesion in NSAIDs group, and also more gastric multiple ulcer than control group, antrum is the most common site for gastric ulcer (P<0.05),while there was more duodenal ulcer in control group; There was more hospital stay in NSAIDs group (P<0.05); But there were no significant differences in sex,drinking,Helicobacter pylori (HP) infection and Hemoglobin level and therapy (P>0.05).Conclusion The patients who are the aged (over 60 years),smoking and concurrent with two NSAIDs or corticosteroids and anticoagulants are more likely to have NSAIDs associated upper gastrointestinal bleeding. Upper gastrointestinal bleeding with no gastrointestinal symptoms is the clinical characteristics of NSAIDs associated upper gastrointestinal bleeding. Gastric ulcer and acute gastric mucosal lesion are the reasons for bleeding, and the most common site for gastric ulcer is antrum. There was more hospital stay in NSAIDs group. The prognosis for NSAIDs associated upper gastrointestinal bleeding is good after aggressive combined therapy.