| Objective: To further understand nonsteroidal anti-inflammatory drugs(NSAIDs)-related peptic ulcers and provide a theoretical basis for clinical diagnosis and prevention of the disease more effectively,the clinical features and epidemiology of inpatients with NSAID-related peptic ulcers in the second affiliated hospital of Dalian medical university over the last 5 years were retrospectively analyzed.Methods: Inpatients diagnosed as peptic ulcer in the second affiliated hospital of Dalian medical university hospital from Oct.2010 to Sept.2017 were searched with the medical record retrieval system of the second affiliated hospital of Dalian medical university hospital,among which 70 cases of NSAID-related peptic ulcers were identified and as the experimental group,and others were patients with non-NSAID-related peptic ulcers.70 patients with non-NSAID-related peptic ulcers were randomly selected as the control group with the SPSS24 statistical software.The following data were collected for both groups : 1.General information,including gender,age,admission season,smoking and drinking history,previous medical history(hypertension,peptic ulcer).2.Symptoms,including abdominal pain,gastrointestinal bleeding,and absence of symptoms.3.Signs,including abdominal tenderness.4.Endoscopic findings: the location,morphology,quantity,and size of the ulcers,and Helicobacter pylori(HP)infection test.Meanwhile,types of drugs used in the experimental group were collected.All the data were retrospectively analyzed using the SPSS 24 statistical software.Results: 1.There were 44 males and 26 females in the experimental group with a male to female ratio of 1.69:1 and a mean age of 66.16±1.434 years,and 48 males and22 females in the control group with a male to female ratio of 2.18:1 and a mean age of 53.26±2.005 years.The numbers of cases with different onset season were 19 inspring,19 in summer,12 in autumn,and 20 in winter for the experimental group and27 in spring,16 in summer,14 in autumn,and 13 in winter for the control group.Statistical difference in age was observed between the two groups(P=0.000,<0.05)with no statistical differences in sex and onset season(p= 0.476 and P =0.349,respectively).There were more males in both groups.The age of NSAID-related peptic ulcer patients was relatively higher than that of patients with non-NSAIDrelated peptic ulcers.2.44.29% and 17.10% of the patients in the experimental group and 28.57%and 17.10% of the patients in the control group were smokers and alcohol users respectively,and 12.86% and 48.57% of the patients in the experimental group and17.14% and 18.57% the patients in the control group had the previous history of peptic ulcer disease and hypertension,respectively.No statistical differences in smoking,alcohol use,and previous history of peptic ulcer were noted between the two groups(p= 0.053,p=1.000,and p=0.478,respectively).There was statistical difference in previous history of hypertension between the two groups(p=0.000,<0.05),and the morbidity rate of hypertension in patients with NSAID-related peptic ulcers was higher than that of patients with non-NSAID-related peptic ulcers.3.There were 34 patients with gastrointestinal bleeding(hematemesis and/or melena),28 with abdominal pain,and 8 without clinical symptoms in the experimental group and 29 with gastrointestinal bleeding(hematemesis or melena),40 with abdominal pain,and 1 without clinical symptoms in the control group.The differences between the two groups were statistically significant(p=0.019,<0.05)and the proportion of patients without clinical symptoms was higer in the NSAID-related peptic ulcer group compared with that of the non-NSAID-related peptic ulcer group.4.44.29% patients in the experimental group and 58.57% patients in the control group had abdominal tenderness and there were no statistical differences in physical signs between the two groups(p=0.091).5.The proportion of patients with gastric ulcer(67.14%)was the highest,followed by duodenal ulcer(24.29%)and compound ulcer(8.57%)in the experimental group,and the proportion of duodenal ulcer(51.43%)was the highest,followed by gastric ulcer(40.00%)and compound ulcer(8.57%)in the control group.The difference in the ulcer location was statistically significant between the two groups(p=0.003,<0.05).Among the patients with gastric ulcer,lesions were most commonly found in gastric antrum(61.69%),followed by gastric horn(25.54%),gastric fundus and gastric body(12.77%)in the experimental group and the most common ulcer location was gastric antrum(57.14%),followed by gastric horn(28.57%),gastric fundus and gastric body(14.29%)in the control group.There was no statistical difference in ulcer location between the two groups of gastric ulcer patients(p=0.927).For patients of both groups,most ulcers were round-like in shapes with single ulcers as the dominant forms and diameters of 0.2~2.0cm.High HP infection rates were observed in both groups.There were no statistical differences between the experimental group and the control group in the shape,number,and size of ulcers as well as the HP infection(p=1.000,0.472,0.654 and 0.301,respectively).6.There were 43(61.43%)patients treated with salicylic acid preparations,6(8.57%)with cyclooxygenase-2 inhibitors and 21(30.00%)with other agents(other than salicylic acid and COX-2 inhibitors),and the differences in the size,shape and numbers of ulcers caused by the three types of medication were not statistically significant(p=0.453,0.768 and 0.716,respectively).Conclusions: In this study,NSAID-related peptic ulcer is more commonly found in males than females.Compared with patients with non-NSAID-related peptic ulcers,the age of onset of NSAID-related peptic ulcers is older with more patients complicated with hypertension and upper gastrointestinal hemorrhage.Some NSAID-related peptic ulcer patients present with no clinical symptoms.NSAID-related peptic ulcers are mostly common found in the stomach,followed by the duodenum,and sometimes both stomach and duodenum are involved.Gastric antrum is the most commonly compromised region in gastric ulcer.Most ulcers are round-like in shapes with single ulcers as the dominant forms and diameters of0.2~2.0cm,and large ulcers are rare in NSAID-related peptic ulcer.Most of the patients with NSAID-related peptic ulcers also are complicated with HP infection.Non-selective COX inhibitors are the leading medication for the development ofNSAID-related peptic ulcers and selective COX-2 inhibitors,however,can also cause peptic ulcer.There are no significant differences in the number,size and shape of ulcers among patients taking different kinds of drugs. |
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