BACKGROUND & AIMS:
:The occurrence of upper gastrointestinal disease and the relevance of nonsteroidal antiinflammatory drug (NSAID) usage were documented in 511 consecutive patients (321 women, 190 men) over 70 yr old, referred for upper gastrointestinal endoscopy in a district general hospital. The findings were benign esophageal disease (43%), normal (15%), gastric ulcer (11.5%), and duodenal ulcer (11%). Gastric ulcers were more common in women taking NSAIDs (25%) than in NSAID abstainers (7%) p less than 0.001 and male NSAID users (8%) p less than 0.001. Esophagitis and esophageal stricture were not influenced by NSAID usage, but gastric erosions were more common (10% vs. 3%) p less than 0.01. Of 142 patients receiving NSAIDs, 41% presented with hemorrhage, compared with 20.5% of NSAID abstainers (p less than 0.001). Hemorrhage was as common in aspirin takers (15 of 33, 45%) as in standard-dose NANSAID takers (43 of 109, 39%), even though 86% were taking 300 mg of aspirin per day or less. In elderly patients, esophageal disease is common. NSAID use, even low-dose aspirin, is associated with an increased risk of hemorrhage. In females, NSAID usage is associated with gastric ulcer.
背景与目标:
:在70岁以上的511例连续患者(321例患者,190例男性患者)中,上消化道疾病的发生和使用非甾体类抗炎药的相关性已有文献记载,这些患者在某地区综合医院进行了上消化道内镜检查。结果为:良性食道疾病(43%),正常(15%),胃溃疡(11.5%)和十二指肠溃疡(11%)。服用NSAIDs的女性(25%)的胃溃疡比不服用NSAID的人(7%)的P <0.001,而男性NSAID使用者(8%)的P <0.001。食道炎和食道狭窄不受NSAID使用的影响,但胃糜烂更为常见(10%比3%),p小于0.01。在142名接受NSAID的患者中,有41%出现了出血,而NSAID的弃权者为20.5%(p小于0.001)。阿司匹林服用者出血(33名中的15名,占45%)和标准剂量NANSAID服用者出血(109名中的43名,39%)一样普遍,尽管86%的人每天服用300毫克或更少的阿司匹林。在老年患者中,食道疾病是常见的。使用非甾体抗炎药,即使是小剂量阿司匹林,也会增加出血的风险。在女性中,NSAID的使用与胃溃疡有关。