Clinical Analysis Of Aspirin In Patients With Cardio Cerebrovascular Disease Complicated With Upper Gastrointestinal Bleeding

Objective To discuss clinical characteristics and disease related risk factors through analysis and research of upper gastrointestinal bleeding for patients with cardio-cerebral vascular diseases by long-term oral aspirin in Hefei No.1 Hospital in recent two years,and to facilitate effective preventive measures in clinical works and provide ideas for diagnosis and treatment of such patients in the region.Method(1)200 patients with cardio-cerebral vascular diseases who took 100 mg aspirin(bayaspirin)for at least three months and endoscopic examination in Hefei No.1 Hospital from September,2015 to September,2017 were collected,and total 98 cases with UGB confirmed by endoscopic examination were set as observation group,and the remaining 102 cases were set as control group,then statistically significant variables were screened to make multi-factor regression analysis,so as to determine independent risk factors and clinical characteristics of such patients.(2)In the above observation group,there were total 66 cases who were helicobacter pylori positive verified by rapid urease test,which was set as Hp positive group,in which patients were divided into positive group 1(n=33)and positive group 2(n=33)in random number table.The remaining 32 cases were set as Hp negative group verified by rapid urease test;patients in Hp negative and positive groups were given esomeprazole sodium intravenous drip,and patients in positive group 1 were given esomeprazole magnesium enteric-coated tablets and anti-Hp conventional treatment on this basis and then followed for 6 months after treatment.UGB and adverse reactions for the patients in various groups were recorded and Hp eradication for the patients in positive group 1 was calculated,and treatment effect was evaluated.Result There was no significant specificity for gastrointestinal tract symptoms of UGB patients with cardio-cerebral vascular diseases caused by long-term oral small-dose aspirin,and bleeding causes were mainly peptic ulcer,and risk factors included advanced age(above 65 years),diabetes history,past ulcer history and Hp infection.Treatment effect for esomeprazole was significant,and total effective rates for Hp positive group 1,positive group 2 and Hp negative group were 90.9%(30/33),81.8%(27/33),87.5%(28/32)respectively and there was no statistical significance(P>0.05);there was no significant difference for incidence of adverse reaction of patients in three groups(P>0.05),rebleeding rates in positive group 1 and 2 had obvious difference,and the result was statistically significant(c2=3.995,P=0.046),and difference of rebleeding rate had no statistical significance between positive 1 and Hp positive group(c2=1.132,P=0.287),and difference of rebleeding rate had statistical significance between positive group 2 and Hp negative group(c2=1.056,P=0.304).Conclusion 1.Advanced age,helicobacter pylori infection,peptic ulcer history and diabetes history are risk factors for the patients suffer from UGB by oral aspirin.2.For patients who suffered from UGB by oral aspirin and were treated by esomeprazole based,their incidence rate of UGB can be reduced by eradicating helicobacter pylori,with better safety.