UPPER GASTROINTESTINAL-BLEEDING IN RELATION TO PREVIOUS USE OF ANALGESICS AND NONSTEROIDAL ANTIINFLAMMATORY DRUGS
UPPER GASTROINTESTINAL-BLEEDING IN RELATION TO PREVIOUS USE OF ANALGESICS AND NONSTEROIDAL ANTIINFLAMMATORY DRUGS
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DOI：
10.1016/0140-6736(91)90744-a
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发表时间：
1991-01-12
期刊：
影响因子：
168.9
通讯作者：
JUAN, J
中科院分区：
文献类型：
--
作者：
LAPORTE, JR;CARNE, X;JUAN, J
为了评估与使用个体非麻醉镇痛药和非甾体抗炎药 (NSAID) 相关的上消化道出血风险，我们对 875 例上消化道出血病例和 2682 名医院对照进行了一项多中心研究。在控制混杂因素的情况下，首次症状出现前一周至少服用一次阿司匹林的总体比值比估计为 7.2（95% 置信区间 5.4-9.6）。 与上消化道出血相关的非阿司匹林 NSAID 为双氯芬酸 (7.9]4.3-14.6[)、吲哚美辛 (4.9]2.0-12.2[)、萘普生 (6.5]2.2-19.6[) 和吡罗昔康 (19.1 [8.2-44.3])。 扑热息痛、丙哌酮和安乃近不会增加风险。 既往胃肠道出血或消化性溃疡病史并未对比值比估计值产生太大影响，比值比估计值因性别而异，且年轻患者的比值比高于老年患者。 然而，老年人上消化道出血的发生率较高。
To assess the risk of upper gastrointestinal bleeding associated with the use of individual non-narcotic analgesics and non-steroidal anti-inflammatory drugs (NSAIDs), a multicentre study of 875 cases of upper gastrointestinal bleeding and 2682 hospital controls was done. With control for confounding factors, the overall odds ratio estimate for aspirin taken at least once during the week before the first symptom was 7.2 (95% confidence interval 5.4-9.6). Non-aspirin NSAIDs associated with upper gastrointestinal bleeding were diclofenac (7.9 ]4.3-14.6[), indomethacin (4.9 ]2.0-12.2[), naproxen (6.5 ]2.2-19.6[), and piroxicam (19.1 [8.2-44.3]). Paracetamol, propyphenazone, and dipyrone did not increase the risk. A previous history of gastrointestinal bleeding or peptic ulcer did not greatly affect odds ratio estimates, which differed according to sex and were higher for younger than for older patients. However, the incidence of upper gastrointestinal bleeding was higher among the elderly.