中华临床医师杂志(电子版) 2017年2月,11卷3期

临床论著

长期小剂量阿司匹林对冠心病患者上消化道损伤血清学的临床评价

宋斌 梁桂玲 李群山 罗迪 黄献华

516001 广东省,惠州市中医医院消化内科
宋斌,Email: songbinszyy@163.com

摘要:  目的 研究长期小剂量服用阿司匹林对冠心病患者上消化道损伤血清学指标的影响及其应用。方法 选取长期服用阿司匹林及未长期服用阿司匹林的冠心病患者分别作为研究组及对照组,均在服用阿司匹林6个月过程中利用胃镜检测患者胃黏膜情况、量表评估消化道症状,并检查患者血清中胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)和胃泌素17(G-17)水平,分析长期服用阿司匹林对胃肠道的影响,并评价血清学检查对长期服用阿司匹林的冠心病患者消化道损伤的检出意义。统计方法采用t检验及χ2检验。结果 在服用阿司匹林6个月后,两组血清学指标水平比较,PGⅠ水平差异不显著,研究组PGⅡ、G-17明显高于对照组(P<0.05);两组胃黏膜损伤程度比较,两组无损伤或轻度损伤(0、1分)的人数差异无统计学意义(χ2=0.785、0.373,P>0.05),而研究组出现中、重度胃黏膜损伤(2、3分)的人数显著高于对照组(χ2=6.746、8.894,P<0.05);在不同程度的胃黏膜损伤水平下,血清学指标PGⅠ、PGⅡ和G-17之间差异均有统计学意义(P<0.05),并且随着胃黏膜的损伤程度的增加,血清学指标的数值也增加。结论 通过检测患者血清中PGⅠ、PGⅡ和G-17水平可以用来评估长期服用小剂量阿司匹林对冠心病患者的上消化道损伤程度。

关键词: 阿司匹林; 消化道损伤; 血清学; 临床评价

惠州市科技计划项目(20150801)

Clinical evaluation of upper gastrointestinal tract injury of serology to patients with coronary heart disease (CHD) with long-term low-dose aspirin using

Song Bin, Liang Guiling, Li Qunshan, Luo Di, Huang Xianhua.

Department of Gastroenterology, Huizhou City Hospital of Traditional Chinese Medicine, Huizhou 516001, China
songbinszyy@163.com

Abstract:  Objective To explore the effect and impact of using long-term low-dose aspirin in patients with coronary heart disease (CHD) of upper gastrointestinal tract injury of serological indexes. Methods Chose CHD patients with/without long-term aspirin as the research/control group. After using aspirin for 6 months, both groups would check-up the damage of gastric mucosa by gastroscopy, assess the upper digestive tract symptom through scale and check levels of PGⅠ, PGⅡ, G-17 in blood. Then to analyze the impact of gastrointestinal tract about long-term use of aspirin and the evaluation of checking out the damage of gastric mucosa by serological testing in CHD patients. The t test and chi-square test were adopted in statistics. Results After using aspirin for 6 months, compared the difference of PGⅠ, PGⅡ, G-17 level in blood, the result showed that there was no statistical difference of research group and the control group in PGⅠ, team in PGⅡ, G-17 were significantly higher than control group (P<0.05); on the gastric mucosa damage level, there's no statistical difference in no symptoms or mild damage (score 0 & 1) (P>0.05) for research group compared with control group but significant difference in moderate or serious damage (score 2 & 3); on the different degree of gastric mucosa damage level, there were significant differences between serological indexes PGⅠ, PGⅡ and G-17 (P<0.05), and with the increase of the gastric mucosa damage, serological indicator values also increased. Conclusion The level of serological indexes PGⅠ, PGⅡ and G-17 can be used to assess long-term use of low-dose aspirin in patients with coronary heart disease damage degree of upper gastrointestinal tract.

Keywords:Aspirin; Digestive tract injury; Serology; Clinical evaluation

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(编辑:马超 收稿日期:2016-10-21)