Relationship Between The Timing Of HP Eradication And The Incidence Of Aspirin-induced Adverse Reactions In Elderly Patients

Objective:To analyze the influence of different Hp eradication timing on the eradication therapy of elderly patients taking aspirin,and to explore the influence of Hp eradication therapy and eradication timing on the adverse reactions caused by aspirin.Methods:This study was a prospective,single-center,observational study(registration number: Chic TR1900025030),approved by the Ethics Committee of China-Japan Union Hospital of Jilin University.In this study,patients admitted to China-Japan Union Hospital of Jilin University between September 2019 and September 2020 who were positive for 13C/14 C urea breath test and met the inclusion criteria,and who took aspirin before or after Hp eradication,were included in a 1:1 ratio.Randomly give quadruple therapy or quadruple therapy combined with probiotics to eradicate Helicobacter pylori.13C/14 C breath test was performed 4 weeks after the end of treatment,and a negative result was considered successful Hp eradication,while a positive result was considered unsuccessful Hp eradication.Baseline symptoms,ADR during Hp eradication treatment and 13C/14C-UBT 4 weeks after Hp eradication were recorded by questionnaire and telephone follow-up.The effects of different Hp eradication timing on the eradication rate and adverse reactions of patients taking aspirin were analyzed.Six months after the eradication of Hp,the effects of successful eradication of Hp and the timing of eradication on the occurrence of Aspirininduced adverse reactions were analyzed.Results:A total of 334 patients completed the study,and the total population eradication rate was 87.4%.Among the elderly and non-elderly patients,the eradication rate of the Hp eradication group after taking aspirin was 86.9% and83.1%,respectively,which showed no significant difference from the eradication rate of the Hp eradication group before taking aspirin(P > 0.05).In the Hp eradication group before taking aspirin and the Hp eradication group after taking aspirin,the eradication rate of the combined probiotics was 90.7%and 86.1%,and there was no significant difference between the eradication rate and that of the non-combined probiotics group(P > 0.05).The incidence of adverse reactions in the total population was 16.8%.In the elderly and non-elderly patients,the incidence of adverse reactions in the Hp eradication group before taking aspirin was 17.2% and 16.3%,respectively,and there was no significant difference in the adverse reaction rates between the Hp eradication group and the aspirin group after taking Hp eradication(P >0.05).The incidence of adverse reactions in patients with Hp eradicated before aspirin and patients with Hp eradicated after aspirin were 5.3% and 6.3%,respectively,which were significantly lower than those in patients without Hp eradicated with probiotics(P = 0.001,P = 0.001).In elderly patients,the incidence of adverse reactions in patients with Hp eradicated before taking aspirin and patients with Hp eradicated after taking aspirin were 5.4% and 7.1%,respectively,which were significantly lower than those without Hp eradicated with probiotics(P = 0.026,0.040).The incidence of adverse events caused by aspirin in patients with successful eradication of Hp was 9.2%,significantly lower than that in patients with unsuccessful eradication of Hp(26.2%)(P = 0.001).Among them,the incidence of abdominal pain,nausea/vomiting and gastrointestinal bleeding were 6.2%,3.1% and 0.34%,respectively,which were significantly lower than those in the group without successful eradication(P = 0.016,0.008,0.043).The incidence of adverse events in patients with Hp eradication before aspirin was6.0%,which was significantly lower than that in patients with Hp eradication after aspirin(P = 0.049).Conclusion:1.The incidence of Aspirin-induced adverse events in patients with successful eradication of Hp was 9.2%,which was significantly lower than that in patients without successful eradication of Hp.2.Among the successfully eradicated patients,the incidence of adverse reactions in the Hp eradicated group before taking aspirin was 6.0%,which was significantly lower than that in the Hp eradicated group after taking aspirin.3.The incidence of adverse reactions during Hp eradication was significantly lower in patients with combined probiotics before/after aspirin treatment than in patients without combined probiotics.