Upper gastrointestinal bleeding in haemophiliacs: incidence and relation to use of non-steroidal anti-inflammatory drugs.
Upper gastrointestinal bleeding in haemophiliacs: incidence and relation to use of non-steroidal anti-inflammatory drugs.
复制标题
血友病患者上消化道出血：发生率及其与非甾体抗炎药使用的关系。
DOI：
10.1111/j.1365-2516.2007.01453.x
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
SecondMulticenterHemophiliaStudyGroup
中科院分区：
文献类型：
--
作者：
Eyster,ME;Asaad,SM;Gold,BD;Cohn,SE;Goedert,JJ;SecondMulticenterHemophiliaStudyGroup
这项多中心研究试图评估血友病患者上消化道(UGI)出血的发生率及其与非类固醇抗炎药(NSAIDs)使用的关系。用COX模型估计假定危险因素的相对危险度(RH)，可信区间(CI)为95%。条件Logistic回归和储存的血清被用来评估幽门螺杆菌阳性的病例与接近匹配的对照组UGI出血的风险。在平均17.4个 月(范围2-34)期间，对2285名年龄在13-89岁(平均36.5岁)的参与者进行了3309个 人年(Y)的跟踪调查。42例患者发生上消化道出血事件(发生率为1.30/100 /Py)，其中溃疡(11例)、胃炎(4例)、静脉曲张(5例)和Mallory Weiss撕裂(8例)是最常见的原因。在1个 月内，传统非甾体抗炎药的RH显著增加(OR：3.6 6；95%CI：1.1~11.9)，但用药后RH无明显变化。RH随年龄和GT；46 (3.5；95%CI：1.1~10.6)和肝功能失代偿(4.4；95%CI：1.7~11.6)的增加而显著增加。出血的可能性随着幽门螺杆菌阳性而显著增加(OR：4.6；95%CI：0.3-83.9)。这些发现表明，在血友病关节病的治疗中，高昔布是一种比传统非类固醇抗炎药更安全的选择。
This multicentre study sought to estimate the incidence of upper gastrointestinal (UGI) bleeding in haemophiliacs and its relationship to use of non‐steroidal anti‐inflammatory drugs (NSAIDs). Cox models were used to estimate relative hazards (RH) with 95% confidence intervals (CI) for postulated risk factors. Conditional logistic regression and stored sera were used to assess UGI bleeding risk withHeliobacter pyloriseropositivity in cases compared with closely matched controls. During a mean of 17.4 months (range 2–34), 2285 participants, ages 13–89 (mean 36.5) were followed for 3309 person‐years (py). Forty‐two experienced a UGI bleeding event (incidence 1.3 per 100 py), most from ulcer (11), gastritis (four), varices (five) and Mallory Weiss tears (eight). RH was significantly increased with traditional NSAID use for <1 month (OR: 3.66; 95% CI: 1.1–11.9), but not with coxibs use. RH was significantly and independently increased with age >46 years (3.5; 95% CI: 1.1–10.6) and hepatic decompensation (4.4; 95% CI: 1.7–11.6). Likelihood of bleeding was substantially but not significantly increased (OR: 4.6; 95% CI: 0.3–83.9) withH. pyloriseropositivity. These findings suggest that coxibs are a safer alternative than traditional NSAIDs in the treatment of haemophilic arthropathy.