The Analysis Of Risk Factors On Gastrointestinal Adverse Effects Caused By NSAIDs

Object:To observe the risk factors on gastrointestinal adverse effects caused by NSAIDs, such as smoking, drinking, Hp infection, concomitant medications and so on. To provide a reference for the primary prevention of the gastrointestinal adverse events, and provide guidance for safety and reasonable application of drugs in clinical.Method:The patients who taking NSAIDs regularly in recent from January1,2009to December31,2011were enrolled in the study. They come from Tianjin First Central Hospital, Tianjin HaiHe Hospital, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, The Second Hospital of Tianjin Medical University, Tianjin NanKai Hospital, and254Hospital of the Chinese People’s Liberation Army, respectively. They were given1,000questionnaires to investigate the risk factors of gastric mucosal injury, such as aging, smoking, drinking, eating habits, the recent availability of stress events, past history, and concomitant medication, etc. And they were underwent endoscopy and Hp check to observe the conditions of gastric mucosal injury if the patients with gastrointestinal symptoms and have no contraindications.Results:1. A total of957patients were enrolled in this study. Male were556(58.10%) while females were401(41.90%). The average age was (64.82±12.49) years. Among these patients, there were649cases who has upper gastrointestinal symptoms and252cases who occured upper gastrointestinal bleeding.2. The rate of gastrointestinal symptoms in patients who take two or more NSAIDs was higher than the patients who take only one NSAIDs (x2=7.345,p=0.007), but there is no statistically significant in the rate of gastrointestinal bleeding.3. The risk factors of upper gastrointestinal symptoms or upper gastrointestinal bleeding in the patients who take NSAIDs.3.1The risk factors of upper gastrointestinal symptoms were age (especially^60years), the presence of bad eating habits, the history of ulcer complications, the history of treatment on upper gastrointestinal disease, a history of rheumatic disease, without the application of anticoagulant drugs, absence of cerebral vascular drugs.3.2The risk factors of upper gastrointestinal bleeding were male, age (especially≥60years), the history of peptic ulcer, without the application of anticoagulant drugs.4. The rate of peptic ulcer checked by endoscopic was higher in Hp positive group than in Hp negative group (x2=11.755, P=0.001). And the incidence of upper gastrointestinal symptoms were higher in Hp positive group than in Hp negative group (x2=3.988, P=0.046); while the incidence of upper gastrointestinal bleeding were higher in Hp positive group than in Hp negative group (x2=0.432, P=0.511).Conclusions:1. NSAIDs can cause gastrointestinal adverse effects, and even can lead to peptic ulcers, gastrointestinal bleeding.2.The risk factors of upper gastrointestinal symptoms caused by NSAIDs were age (especially≥60years), bad eating habits, a history of ulcer complications, the history of treatment on upper gastrointestinal disease, a history of rheumatic disease, without the application of anticoagulant drugs and cerebral vascular drugs, take two or more NSAIDs at the same time.3. The risk factors of gastrointestinal bleeding caused by NSAIDs were male, age (especially≥60years), a history of peptic ulcer and without the application of anticoagulant drugs.4. Hp infection was the risk factor for peptic ulcer. The rate of dyspeptic symptoms and gastrointestinal bleeding in the patients who take NSAIDs and Hp positive simultaneously were higher than Hp negative.In summary, the application of NSAIDs, especially used in long-terms, should be reasonable, safty, and individual. If necessary, gastric mucosal protective drugs or PPI should be plused. Hp should be cleared if merger with Hp infection.