Gastrointestinal hemorrhages as complications of gastropathies associated with intake of nonsteroid anti-inflammatory drugs
- Authors: Shostak NA1, Ryabkova AA1, Savelyev VS1, Malyarova LP1
-
Affiliations:
- Issue: Vol 78, No 5 (2003)
- Pages: 70-73
- Section: Editorial
- Submitted: 09.04.2020
- Published: 15.05.2003
- URL: https://ter-arkhiv.ru/0040-3660/article/view/29395
- ID: 29395
Cite item
Full Text
Abstract
Aim. To examine gastroduodenal mucosa in patients treated with nonsteroidal anti-inflammatory drugs (NSA1D), to evaluate the rate and severity of gastrointestinal hemorrhage (GIH) as NSAIDgastropathy manifestation by the results of clinical and device tests.
Material and methods. A retrospective analysis of 2042 case histories of patients admitted to the surgical department of the Moscow city hospital N 1 in 1997-2001 with diagnosis GIH confirmed at esophagogastroduodenoscopy (EGDS). 989 patients (566 males and 423 females) had acute GIH from the upper gastrointestinal tract.
Results. Relationship between intake of N SAID and GIH was documented in 342 patients (16. 7% of overall number of the examinees and 34.6% of patients with acute GIH). According to EGDS, GIH was provoked by gastric lesions (68%), duodenal lesions (20%), gastroduodenal lesions (9%), esophageal erosions (3%). GIH was caused primarily by low-dose aspirin, indometacin, diclofenak and ibuprofen. Severe GIH occurred in 28.9% cases, moderate and mild ones in 20.8 and 50.3%, respectively. Conclusion. To reduce the incidence of GIH, it is necessary to take preventive measures against NSAId-gastropathies.
Material and methods. A retrospective analysis of 2042 case histories of patients admitted to the surgical department of the Moscow city hospital N 1 in 1997-2001 with diagnosis GIH confirmed at esophagogastroduodenoscopy (EGDS). 989 patients (566 males and 423 females) had acute GIH from the upper gastrointestinal tract.
Results. Relationship between intake of N SAID and GIH was documented in 342 patients (16. 7% of overall number of the examinees and 34.6% of patients with acute GIH). According to EGDS, GIH was provoked by gastric lesions (68%), duodenal lesions (20%), gastroduodenal lesions (9%), esophageal erosions (3%). GIH was caused primarily by low-dose aspirin, indometacin, diclofenak and ibuprofen. Severe GIH occurred in 28.9% cases, moderate and mild ones in 20.8 and 50.3%, respectively. Conclusion. To reduce the incidence of GIH, it is necessary to take preventive measures against NSAId-gastropathies.
Keywords
References
- Насонов Е. Л. Нестероидные противовоспалительные препараты при ревматических заболеваниях: стандарт лечения. Рус. мед. журн. 2001; 9(7-8): 265-270.
- Hudson N., Taha A. S., Russel R. I. Famotidie for healing and maintenance in nonsteroidal anti-inflammatory drug-assiciated gastroduodenal ulceration. Gastroenterology. 1997; 112(6): 1817-1822.
- Lanza F. L. Am. J. Gastroenterol. 1998; 93: 2037-2046.
- Vane J. R. Nature 1971; 231: 232-235.
- Муравьев Ю. В., Гринько А. В. Нестероидные противовоспалительные препараты и желудочно-кишечный тракт. Рус. мед. журн. 1998; 13: 829-831.
- Насонова В. А., Каратеев А. Е. Распространенность, структура и факторы риска развития гастропатии, индуцированных нестероидными противовоспалительными препаратами. Рос. журн. гастроэнтерол., гепатол., колопроктол. 2000; 40.
- Roth S. H., Bennett R. E. Non-steroidal anti-inflammatory drug gastropathy. Arch. Intern. Med. 1987; 147: 2093-2100.
- Graham D. Y., Agrawal N. M., Roth S. Lancet 1988; 2: 1318- 1323.
- Hawkey С. J., Cullen D. J. E., Pearson G. et al. Pharmacoepidemiology of non-steroidal anti-inflammatory drug use in Nottingham general practices. Aliment. Pharmacol. Ther. 2000; 14: 177-185.
- Langham M. J. S., Weil J., Wainwright P. et al. Risks of bleeding peptic ulcer associated with individual nonsteroidal anti-inflammatory drugs. Lancet 1994; 343: 1075-1078.
- Cullen D. J. E., Hawkey G. M., Greenwood D. C. Peptic ulcer bleeding in the elderly relative roles of Helicobacter pylory and non-steroidal anti-inflammatory drugs. Gut. 1997; 41(4): 459- 462.
- Larkai E. N., Smith J. L., Lidsky M. D., Graham D. Y. Gactroduodenal mucosa and dyspeptic symptoms in arthritis patients during chronic nonsteroidal antiinflammatory drug use. Am. J. Gastroenterol. 1987; 82: 1153-1158.
- MacDonald T. M., Morant S. V., Robinson G. С. et al. Association of upper gastrointestinal toxicity of nonsteroids anti-inflammatory drugs with continued exposure: cohort study. Br. Med. J. 1997; 315: 1333-1337.
- Барашков В. Т., Сергеев П. В. Осложненные гастродуоденальные язвы у ревматологических больных. Вестн. хир 1988; 4: 28-31.
- Шостак Н. А., Малярова Л. П., Рябкова А. А., Федорова Е. Д. К вопросу о желудочно-кишечных кровотечениях, индуцированных нестероидными противовоспалительными препаратами. Вестн. РГМУ 1999; 5(10): 72-77.
- Forrest J. A., Finlayson N. D. Endoscopy in gastrointestinal bleeding. Lancet 1974; 2: 394-399.
- Стручков В. И., Луцевич Э. В., Белов И. Н, Стручков Ю. В. Желудочно-кишечные кровотечения и фиброэндоскопия. М.; 1977.