2019 年第 11 期 第 14 卷

服用肠溶阿司匹林患者小肠黏膜损伤的危险因素初探

A preliminary study on the risk factors of small intestinal mucosal injury in patients taking enteric-coated aspirin

作者：高峰张杰陈雪

英文作者：

单位：100029首都医科大学附属北京安贞医院消化内科

英文单位：

关键词：小肠黏膜损伤；肠溶阿司匹林；胶囊内镜；危险因素

英文关键词：

• 摘要：

• 【摘要】目的    初步探讨服用肠溶阿司匹林患者小肠黏膜损伤的危险因素。方法    选取2017年9月至2019年6月在首都医科大学附属北京安贞医院就诊的服用肠溶阿司匹林患者60例，均行胶囊内镜检查观察小肠黏膜的损伤情况，收集患者临床资料，根据是否存在小肠黏膜损伤将所有患者分为无损伤组（23例）和损伤组（37例）。分析阿司匹林相关小肠黏膜损伤的危险因素。结果    60例服用肠溶阿司匹林患者中37例(61.7%)存在至少1处小肠黏膜损伤（糜烂或溃疡），其中大的糜烂和/或溃疡9例(15.0%)。损伤组患者年龄、服用肠溶阿司匹林时间较无损伤组明显增加［（60±9）岁比（55±9）岁、24.0(6.0,84.0)个月比8.0(2.0,12.0)个月］，差异均有统计学意义（均P＜0.05）。二元Logistic回归单变量分析结果显示，年龄≥60岁及服用肠溶阿司匹林时间＞12个月为患者出现小肠黏膜损伤的危险因素（比值比=7.500、5.914，95%置信区间：2.244～25.062、1.794～19.498，P=0.001、0.003)。结论    61.7%的服用肠溶阿司匹林患者存在不同程度小肠黏膜损伤，年龄≥60岁和服药时间＞12个月是患者出现小肠黏膜损伤的危险因素。

• 【Abstract】Objective    To investigate the risk factors of intestinal mucosal injury in patients taking enteric-coated aspirin. Methods    From September 2017 to June 2019, 60 patients taking enteric-coated aspirin were enrolled in Beijing Anzhen Hospital, Capital Medical University. According to capsule endoscopy findings, the patients were divided into non-injury group(23 cases) and intestinal mucosal injury group(37 cases). Associated clinical data were collected and the risk factors of aspirin-related intestinal mucosal injury were analyzed. Results    There were 37 patients had（61.7%） more than one lesion（erosion or ulcer） on intestinal mucosa, including 9 cases of large erosion and/or ulcer. Age and the time of taking aspirin in the intestinal mucosal injury group were significantly higher/longer than those in the non-injury group［（60±9）years vs （55±9）years, 24.0(6.0,84.0)months vs 8.0(2.0,12.0)months］（both P＜0.05）. Univariate and binary logistic regression showed that age≥60 years old and the time of taking enteric-coated aspirin＞12 months were risk factors of intestinal mucosal injury（odds ratio=7.500, 5.914; 95% confidence interval： 2.244-25.062, 1.794-19.498; P=0.001, 0.003). Conclusions    This study demonstrates a rate of 61.7% of intestinal mucosal injury affecting patients taking enteric-coated aspirin. Age≥60 and aspirin using period＞12 months are risk factors of intestinal mucosal injury.