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目的观察湖南省非甾体类抗炎药相关性胃肠粘膜疾病的发生规律、影响因素及防治情况,减少消化道并发症的发生和死亡率。方法 (1)采用临床流行病学调查研究的方法,分析湖南省有NSAIDs服药史的患者的胃肠黏膜损害的发生情况,总结其影响因素。(2)在调查中采用成组病例对照研究方法,随机选择具有可比性的120例使用非甾体类抗炎药的患者分别给予不同药物干预,观察分析结果。结果 (1)共调查湖南省32家医院的10 080例患者,回收合格问卷9 044份,出现消化道症状4 778例,其中消化道出血1 166例。(2)非甾体类抗炎药相关性胃肠粘膜损害与性别无关(P>0.05),与患者的年龄、服药时间、是否联合用药、幽门螺杆菌感染、吸烟、饮酒等一般情况有关(P<0.05)。(3)预防性使用质子泵抑制剂或粘膜保护剂的消化道症状发生率明显低于不用药者(P<0.05)。结论调查研究结果显示,年龄大于60岁,有幽门螺杆菌,且抽烟、喝酒,有合并用药的服药者易患NSAIDs相关性胃肠病,给予胃肠黏膜药物干预,发病率可明显下降。
Objective To observe the occurrence, influencing factors and prevention and treatment of gastrointestinal mucosal diseases associated with non-steroidal anti-inflammatory drugs in Hunan Province and to reduce the incidence and mortality of gastrointestinal complications. Methods (1) The clinical epidemiological investigation method was used to analyze the incidence of gastrointestinal mucosal lesions in patients with NSAIDs taking medicine in Hunan Province, and the influencing factors were summarized. (2) In a case-control study, a group of 120 randomly selected non-steroidal anti-inflammatory drugs were randomly assigned to receive different drug interventions and the results were observed and analyzed. Results (1) A total of 10 080 patients from 32 hospitals in Hunan Province were investigated. 9 044 qualified questionnaires were recovered. There were 4 778 gastrointestinal symptoms, including 1 166 gastrointestinal bleeding. (2) The non-steroidal anti-inflammatory drug-related gastrointestinal mucosal damage has nothing to do with gender (P> 0.05), and the patient’s age, medication time, whether combined with medication, Helicobacter pylori infection, smoking, drinking and other general conditions P <0.05). (3) Preventive use of proton pump inhibitors or mucosal protective agent of the incidence of gastrointestinal symptoms was significantly lower than those who did not medication (P <0.05). Conclusions The investigation and research results show that H.pylori is older than 60 years old. Smoking, drinking and medication with combination therapy are predisposed to NSAIDs-related gastroenteric diseases. Intervention with gastrointestinal mucosa may reduce the incidence of NSAIDs.