Objective To observe the changes of coagulation-related indicators in patients with gastrointestinal bleeding induced by non-steroidal anti-inflammatory drugs (NSAIDs) and to explore its risk factors.
Methods A total of 108 patients with gastrointestinal bleeding induced by NSAIDs were selected as bleeding group, and 108 patients who administrated NSAIDs without gastrointestinal bleeding were selected as non-bleeding group. The clinical materials and coagulation-related indicators activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), fibrinogen (Fib), D-dimer (D-D) and platelet count (PLT) of the two groups were compared, and the risk factors of NSAIDS-related upper gastrointestinal bleeding were analyzed.
Results The age, proportions of patients with smoking history and drinking, Helicobacter pylori (Hp) infection rate, proportion of patients with a history of cerebrovascular disease, proportion of patients with a history of chronic gastritis, proportion of patients with a history of medication time of NSAIDs >12 months, medication rate of aspirin, rate of combination medication ≥2 kinds of NSAIDs, and medication rate of spironolactone in the bleeding group were higher than those in the non-bleeding group, and the usage rates of proton pump inhibitor (PPI) and gastric mucosal protective agent were lower than those in the control group (P < 0.05 or P < 0.01). There were no statistically significant differences in PT, TT, APTT, Fib, D-D and PLT between the two groups (P>0.05). Multivariate Logistic regression analysis showed that use of PPI and gastric mucosal protective agents were protective factors for gastrointestinal bleeding induced by NSAIDs(P < 0.05 or P < 0.01), while older age, smoking, drinking, complicating with Hp infection, coronary heart disease, cerebrovascular diseases, chronic gastritis, administration of aspirin, administration of ≥2 NSAIDs medicine, NSAIDs medication for a long time, combined administration of spironolactone and combined administration of clopidogrel were independent risk factors of gastrointestinal bleeding (P < 0.05 or P < 0.01).
Conclusion Patients with gastrointestinal bleeding induced by NSAIDs have no significant change in coagulation-related indicators, but those with advanced age, smoking and drinking, history of cardiovascular and cerebrovascular diseases, Hp infection or history of chronic gastritis, long-term use of NSAIDs or multi-drug combination are more likely to develop NSAIDs-related gastrointestinal bleeding. Individualized treatment for high-risk factors, PPI and gastric mucosal protective agents have preventive effects for gastrointestinal bleeding induced by NSAIDs.
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