Clinical Analysis Of Non-Steroidal Anti-Inflammation Drugs Associated Upper Gastrointestinal Bleeding

ObjectiveTo investigate the clinical and endoscopic characteristics of non-steroidal anti-inflammatory drugs (NSAIDs) associated upper gastrointestinal bleeding.MethodsClinical data of patients with upper gastrointestinal bleeding from January 2002 to December 2006 were collected from Qilu Hospital of Shandong University, Shandong Province Hospital and Jinan Central Hospital. Age, gender, clinical manifestations, history of peptic ulcer and cardio-cerebral-vascular diseases, hemoglobin level, length of stay and endoscopic characteristics were included. According to the history of taking NSAIDs or not during 10 days before bleeding, the patients were divided into two groups. The clinical and endoscopic characteristics were further analyzed.ResultsClinical data of 523 patients with upper gastrointestinal bleeding were collected. 197(37.7%) patients took NSAIDs during 10 days before bleeding. There was significant difference between NSAIDs group and no NSAIDs group in age, gender, history of cardio-cerebral-vascular diseases, hemoglobin level, length of stay and endoscopic characteristics. 64.5% in NSAIDs group applied NSAIDs to treat cardio-cerebral-vascular diseases, others for respiratory infection and connective tissue diseases, etc. The most frequently used NSAIDs drug was aspirin (61.6%) while procetol and ibuprofen were often used, too. Patients taken NSAIDs for more than 10 days occupied 61.9% in NSAIDs group. After treatment with fluid replacement, haemostasis and protecting gastrointestinal mucosa, all patients recovered, except for four patients dying from cardio-cerebral-vascular diseases.ConclusionsAdvanced age is a risk factor for NSAIDs associated upper gastrointestinal bleeding. The percentage of female patients over 60 years old in NSAIDs group is larger than no NSAIDs group, which may be due to poor protection of estrogen from tissue injury of NSAIDs in elder women. Clinical manifestations of NSAIDs group are more delitescent while bleeding is more serious. Endoscopy shows that tissue injury tends to exist in gastric mucosa. Following efficient treatment, the prognosis for NSAIDs associated upper gastrointestinal bleeding is good. How to prevent NSAIDs associated upper gastrointestinal bleeding is worth further research.