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目的 探讨2型糖尿病患者发生阿司匹林所致胃肠道出血的危险因素。方法 回顾性分析2011年 1月1日至2017年6月31日广州军区广州总医院内分泌科1 087例住院2型糖尿病患者的病历资料,均持续口服阿司匹林肠溶片100 mg/次,1次/d,服药时间≥7 d。发生胃肠道出血事件的患者归为出血组(152例),其余患者为非出血组(935例)。详细记录患者的各项临床资料并进行组间单因素分析和Logistic回归分析。结果 单因素分析结果显示,出血组患者年龄、吸烟、饮酒、消化道疾病的构成比明显高于非出血组[(70±11)岁比(65±12)岁、74.3%(113/152)比63.4%(593/935)、40.8%(62/152)比25.8%(241/935)、18.4%(28/152)比7.8%(73/935)],差异均有统计学意义(均P<0.05)。Logistic回归分析结果显示,年龄(比值比=2.559,P=0.030,95%置信区间:1.093~5.989)和饮酒(比值比=2.039,P=0.023,95%置信区间:1.102~3.771)是2型糖尿病患者发生阿司匹林所致胃肠道出血的危险因素。结论 高龄及长期饮酒是2型糖尿病患者发生阿司匹林所致胃肠道出血的高危因素。
Objective To analyze the risk factors of gastrointestinal bleeding caused by aspirin in patients with type 2 diabetes mellitus. Methods Totally 1 087 type 2 diabetic patients admitted from January 1st, 2011 to June 31st, 2017 in General Hospital of Guangzhou Military Command of People′s Liberation Army were retrospectively analyzed; all patients took bayaspirin enteric-coated tablets 100 mg/time, 1 time/d. Gastrointestinal bleeding occurred in 152 cases(bleeding group)and 935 cases were non-bleeding group. Related indicators of aspirin-induced gastrointestinal bleeding were analyzed by single-factor test and logistic regression test. Results Age, smoking ratio, alcohol-drinking ratio and gastrointestinal disease ratio in bleeding group were significantly higher than those in non-bleeding group[(70±11)years vs (65±12)years, 74.3%(113/152) vs 63.4%(593/935), 40.8%(62/152) vs 25.8%(241/935), 18.4%(28/152) vs 7.8%(73/935)](P<0.05). Logistic regression showed that advanced age(odds ratio=2.559, P=0.030, 95% confidence interval: 1.093-5.989) and alcohol-drinking(odds ratio=2.039, P=0.023, 95% confidence interval: 1.102-3.771) were risk factors of aspirin-induced gastrointestinal bleeding. Conclusion Advanced age and alcohol-drinking are risk factors of gastrointestinal bleeding caused by aspirin in patients with type 2 diabetes mellitus.
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