中老年男性人群长期口服抗凝药物后的胃镜随访结果

Follow-up results of gastroscope for middle and aged male population with long-term oral Aspirin

摘要:

目的   分析中老年男性人群长期口服阿司匹林后消化道黏膜损伤情况及其变化趋势。方法   选取2000年1月-2014年12月于该院行胃镜检查的长期口服阿司匹林（≥3年）的287例中老年男性患者为研究对象，收集其胃镜随访结果，分析不同随访过程中消化道黏膜损伤数目、严重程度、病变类型及发病部位的变化趋势。结果   全部患者平均胃镜随访5.8年，平均每例患者行胃镜随访8.8次。随访中共检出5 008处消化道黏膜损伤，平均每次胃镜检出1.98处。随访第1年的消化道黏膜损伤数目及改良Lanza评分明显高于初次检查（P <0.05），第3、5和10年的损伤数目及改良Lanza评分均明显低于初次检查（P <0.05）。在随访的各个时期，消化道黏膜糜烂的检出数目明显多于点状出血与溃疡（P <0.05），点状出血的检出数目明显多于溃疡（P <0.05）。胃窦及胃体处消化道黏膜损伤的检出数目明显高于其他各部位（均P <0.05）。幽门螺旋杆菌（Hp）感染患者消化性溃疡、上消化道出血的发生率明显高于未感染者（P <0.05）。结论   长期口服阿司匹林的中老年男性人群容易在第1年出现消化道黏膜损伤，之后损伤数目及程度均呈现平缓下降的趋势，糜烂是最常见的损伤类型，损伤的部位主要集中在胃窦及胃体，Hp感染可增加消化性溃疡及出血的风险。

Abstract:

Abstract: Objective To analyze the changing tendency of gastrointestinal mucosal injury for middle and aged male population with long-term oral Aspirin. Methods 287 middle and aged male population with long-term oral Aspirin (more than 3 years) from January 2000 to December 2014 were enrolled the study, then collect their follow-up results of gastroscope and analyze the change trend of number, severity of injury, lesions type and pathogenic site of gastrointestinal mucosal injury. Results The average follow-up time was 5.8 years and one person was followed up 8.8 times averagely by gastroscope. A total of 5008 gastrointestinal mucosal injury lesions were detected and the mean number was 1.98 per person for once. The number and Modified Lanza's Score of the 1st year were all significantly higher than that of initial gastroscope (P < 0.05), and that of the 5th, 10th and 15th were all significantly lower than that of initial gastroscope (P < 0.05). In all follow-up time, the number of erosion was more than petechia and ulcer (P < 0.05), and the number of petechia was more than ulcer (P < 0.05). The number of gastric antrum and body were all more than other sites (P < 0.05). The incidence of peptic ulcer and upper gastrointestinal hemorrhage of patients with Helicobacter pylori (Hp) infection were all significantly higher than that of those without Hp infection (P < 0.05). Conclusions Gastrointestinal mucosal injury could easily occur in the 1st year for middle and aged male population with long-term oral Aspirin, then its number and severity are in descending trend. Erosion is the most common lesions type and gastric antrum and body are the most common pathogenic site. Hp infection may increase the risk of the peptic Ulcer and bleeding.