OBJECTIVE To evaluate the endoscopic characteristics of gastric ulcers in patients who were using non-steroidal anti-inflammatory drugs (NSAIDs) and were infected with Helicobacter pylori remain.METHODS A total of 379 patients with active-stage gastric ulcer were divided into three groups:H.pylori-positive patients using neither ibuprofen nor LDA (control group,n =216),H.pylori-positive or-negative patients using ibuprofen(IBF group,n =100),and H.pylori-positive ornegative patients using LDA (LDA group,n =63).The differences among these groups in endoscopic characteristics of the ulcers (site,multiplicity,and morphology) were determined.The influence of an antacid drug,i.e.,a proton pump inhibitor (PPI) or a histamine H2 receptor antagonist (H2RA),was also investigated.RESULTS The Ibuprofen group,regardless of H.pylori infection status,had higher incidences of antral,multiple,and irregularly shaped ulcers.The LDA group had a higher incidence of antral ulcers in H.pylori-negative patients and,regardless of H.pylori infection status,a higher incidence of multiple ulcers.However,the incidence of irregularly shaped ulcers in the LDA group did not differ from that in the control group.Neither the concomitant use of an antacid nor the dosing period of ibuprofen affected the results.CONCLUSION The ulcer induced by IBF occurs frequently in the lower part of the stomach (gastric antrum),manifesting as irregular shape while multiple ulcer is often induced by LDA.The main reason for morphological endoscopic feature inference ulcer ulcer has important clinical significance.%目的:了解幽门螺杆菌感染患者服用不同的非甾体类抗炎药(NSAIDs)后发生胃溃疡的内镜特征.方法:对379例处于活动期胃溃疡的患者进行了研究,患者分为3组:(1)未使用布洛芬(IBF)和LDA(小剂量阿司匹林)的幽门螺杆菌-阳性患者(对照组,n=216)；(2)使用布洛芬的幽门螺杆菌-阳性或阴性患者(IBF组,n=100)；(3)使用LDA的幽门螺杆菌-阳性或阴性患者(LDA组,n=63).观察了3组患者在内镜下的溃疡特征(部位、多样性和形态).结果:在IBF组,无论有无幽门螺杆菌感染,都具有较高发生的胃窦部不规则溃疡的发生率.LDA组在幽门螺杆菌阴性患者中,具有较高的胃窦溃疡发生率,而且无论有无幽门螺杆菌感染,都具有较高的多重溃疡发生率.LDA组不规则形状溃疡的发生率则与对照组没有差异.结论:由IBF诱发的溃疡经常发生在胃下部(胃窦),常表现为不规则的形状.而LDA引发的溃疡则具有较高的多重溃疡发生率.研究对于根据溃疡的形态内镜特征推理溃疡发生的主要原因具有重要临床意义.
展开▼
