TO Analysis The Relationship Between Helicobacter Pylori Infection And Non-steroidal Anti-inflammatory Drugs In Peptic Ulcer With Bleeding

Objective:To analyze the interactions between Helicobacter Pylori (Hp) infection and non-steroidal anti-inflammatory drugs(NSAID) use in peptic ulcer with bleeding, to be clear about whether H.Pylori infection and NSAIDs use in coordination with each other in Peptic ulcer with bleeding, and to analyze the clinical features of patients with H.pylori postive PUB.Methods:There was a case-control study between two groups. The peptic ulcer bleeding groups consisted of257peptic ulcer bleeding patients who were diagnosed with endoscopy, the non-bleeding peptic ulcer groups consisted of305patients. The patients of these groups were both admitted to The Center Hospital of Zibo in the some time from2006.3to2010.11. H.pylori check on the rapid urease test、14C urea expiratory experiment and histological examination. We analyzed the difference of NSAIDs use history and the H.pylori infection status between this two groups. We get the OR value and the95%C.I of the exposed factor(H.pylori infection; NSAIDs use) to peptic ulcer with mono-agent and multi-agent analysis.Result:Peptic ulcer with bleeding group H.pylori(+) with195(75.88%), Take NSAIDs137patients (53.31%).The control group305cases H.pylori(+)268cases (87.87%), Take NSAIDs74cases (24.26%).NSAIDs significantly increased the risk of chronic peptic ulcer bleeding(OR=3.56,95%CI=1.22-10.98)。H.pylori itself does not increase ulcer risk of bleeding(OR=0.43,95%CI=0.18-1.62)。Taking NSAIDs merger H.pylori infected patients suffering from gastrointestinal bleeding ulcer increased risk of4.54times, slightly lower than simply taking NSAIDs and pure H.pylori infected patients with upper gastrointestinal bleeding ulcer occurred OR value sum; While taking NSAIDs merger H.pylori infected duodenal ulcer patients suffering from the risk of gastrointestinal bleeding and, OR did not increase the value of0.93(95%C.I0.25—4.13)。In the peptic ulcer with bleeding group and control group, taking NSAIDs patients H.pylori infection reduced(63.5%、75.7%vs90%、91.8%).Taking NSAIDs bleeding groups of patients H.pylori rate was (63.5%(87/137), Taking NSAIDs non-bleeding groups of patients H.pylori infection rate was75.7%(56/74), There was no significant difference between compared(X2=3.26, P>0.05).The study of the risk between ulcer bleeding and time of NSAIDs use finds, the OR value of suffering ulcer bleeding in occasional, frequently and long-term administrated Patients is3.41,3.69and3.56respectively. There is no significant difference in every groups.Clinical features of H.pylori positive bleeding ulcers:the percentage of abdominal pain in H.pylori positive group was higher than that in H.pylori ngeative group (61.5%vs38.7%,P<0.01). More patients in H.pylori negative group were comorbidded with hypertension disease than those patients in H.pylori positive group(17.7%vs8.2%, P<0.05).Conclusions:1、Taking NSAIDs can obviously increase gastric and duodenal ulcer patient upper gastrointestinal bleeding risk; H.pylori infection does not increase and decrease gastric and duodenal ulcer risk of upper gastrointestinal bleeding.2、NSAID can decrease H.pylori infection. H.pylori infection is not in coordination with NSAIDs use in bleeding peptic ulcer morbidity.3、NSAIDs use lasting different days can increase the risk of bleeding Peptic ulcer obviously, but the risk of bleeding Peptic ulcer is not different in the Patients of occasionally, frequently and long-term NSAIDs use.4、Patients with H.pylori positive peptic ulcer bleeding have more abdominal pain; patients with H.pylori negative peptic ulcer bleeding have more hypertension.