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| Clinical evaluation of serum gastric function detection for warning of NSAIDS-related gastric hemorrhage |
| CHEN Minyan1 NIE Xinlai2 JIA Yuting1 MA Yun1 JIN Lingyan1 |
1.Health Management Center, the Second People’s Hospital of Jingdezhen, Jiangxi Province, Jingdezhen 333000, China;
2.Department of Neurology, the Second People’s Hospital of Jingdezhen, Jiangxi Province, Jingdezhen 333000, China |
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Abstract Objective To investigate the predictive value of serum gastric function indexes in patients with non-steroidal anti-inflammatory drugs (NSAIDs) related gastric hemorrhage. Methods A total of 191 patients with chronic diseases who received NSAIDs (Aspirin) in the Second People’s Hospital of Jingdezhen City, Jiangxi Province from May 2020 to May 2022 were selected as the study objects. According to the occurrence of gastric hemorrhage during three months of treatment, they were divided into bleeding group and no bleeding group. The levels of serum gastric function indexes before and after treatment were compared between the two groups. The influencing factors of gastric hemorrhage and the prediction effect of serum gastric function index on gastric hemorrhage were analyzed. Results The incidence of gastric hemorrhage within three months after NSAIDs treatment was 9.95%. There were statistically significant differences in age, history of alcoholism, history of digestive tract and, use of gastric mucosal protective agents between the two groups (P＜0.05). There were statistically significant differences in serum gastrin-17 (G-17), pepsinogen (PG) Ⅰ, PGⅡ, and PGⅠ/PGⅡ between the two groups (P＜0.05). After two months of treatment, the G-17 level in the bleeding group was lower than that before and after one month of treatment, and lower than that in the non-bleeding group. The levels of PGⅠ, PGⅡ, and PGⅠ/PGⅡ were higher than those before treatment and after one month of treatment, and higher than those in non-bleeding group, the differences were statistically significant (P＜ 0.05). Logistic regression analysis showed that age, history of alcoholism, history of digestive tract, gastric mucosal protective agents, serum G-7, PG-Ⅰ, PG-Ⅱ, and PG-Ⅰ/PG-Ⅱ levels after two months of treatment were all influential factors in the occurrence of gastric hemorrhage (P＜0.05). After two months of treatment, the AUC of serum G-17, PG-Ⅰ, PG-Ⅱ, and PG-Ⅰ/PG-Ⅱ combined predicted gastric hemorrhage was 0.879, which was higher than that predicted by any single index, and the differences were statistically significant (P＜0.05). Conclusion The different expression of serum gastric function index in patients with NSAIDs related gastric hemorrhage, combined detection of serum gastric function index has a certain predictive value for gastric hemorrhage.
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[1] Bindu S，Mazumder S，Bandyopadhyay U. Non-steroidal anti-inflammatory drugs （NSAIDs） and organ damage： A current perspective [J]. Biochem Pharmacol，2020，180（1）：114147- 114157.
[2] So H，Tam LS. Nonsteroidal anti-inflammatory drugs and cardiovascular disease risk in spondyloarthritis-spectrum diseases [J]. Curr Opin Rheumatol，2022，34（4）：203-208.
[3] Azh N，Barzkar F，Motamed-Gorji N，et al. Nonsteroidal anti-inflammatory drugs in acute viral respiratory tract infections：An updated systematic review [J]. Pharmacol Res Perspect，2022，10（2）：e00925-e00935.
[4] Wong GLH，Lau LHS，Ching JYL，et al. Prevention of recurrent idiopathic gastroduodenal ulcer bleeding：a double bli- nd，randomised trial [J]. Gut，2020，69（4）：652-657.
[5] Wang JX，Cao YP，Su P，et al. Serum gastrin-17 concentration for prediction of upper gastrointestinal tract bleeding risk among peptic ulcer patients [J]. World J Clin Cases，2021，9（35）：10948-10955.
[6] 葛均波，徐永健.内科学[M].8版.北京：人民卫生出版社，2013：227-255.
[7] 中国高血压防治指南修订委员会.中国高血压防治指南（2010年修订版）[J].中国实用乡村医生杂志，2012，19（10）：1-12.
[8] 中华医学会风湿病学分会.2018中国类风湿关节炎诊疗指南[J].中华内科杂志，2018，57（4）：242-251.
[9] 中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志，2015，48（4）：246-257.
[10] 抗血小板药物消化道损伤的预防和治疗中国专家共识组.抗血小板药物消化道损伤的预防和治疗中国专家共识（2012更新版）[J].中华内科杂志，2013，52（3）：264- 270.
[11] Stolow E，Moreau C，Sayana H，et al. Management of Non- Variceal Upper GI Bleeding in the Geriatric Population： An Update [J]. Curr Gastroenterol Rep，2021，23（4）：5-15.
[12] 中华医学会病理分会消化病理学组筹备组.慢性胃炎及上皮性肿瘤胃黏膜活检病理诊断共识[J].中华病理学杂志，2017，46（5）：289-293.
[13] Sanz Segura P，García Cámara P，Gotor Delso J，et al. Upper gastrointestinal bleeding due to overdose of selective serotonin reuptake inhibitors and nonsteroidal anti-inflammatory drugs [J]. Gastroenterol Hepatol，2019，42（10）：622- 623.
[14] Gupta K，Chawla PA，Sharma D. Synthetic Strategies Towards Safer NSAIDs Through Prodrug Approach：A Review [J]. Mini Rev Med Chem，2021，21（15）：2065-2102.
[15] Lin Z，Bian H，Chen C，et al. Application of serum pepsinogen and carbohydrate antigen 72-4 （CA72-4） combined with gastrin-17 （G-17） detection in the screening，diagnosis，and evaluation of early gastric cancer [J]. J Gastrointest Oncol，2021，12（3）：1042-1048.
[16] Cai Q，Zhu C，Yuan Y，et al. Development and validation of a prediction rule for estimating gastric cancer risk in the Chinese high-risk population：a nationwide multicentre study [J]. Gut，2019，68（9）：1576-1587.
[17] 陈斌，梁心慧，曹刚，等.血清胃功能检测奥美拉唑治疗非甾体抗炎药相关胃黏膜损伤的机制[J].河北医药，2018， 40（15）：2302-2305.
[18] Leja M，Linē A. Early detection of gastric cancer beyond endoscopy-new methods [J]. Best Pract Res Clin Gastroenterol，2021，50（1）：101731-101741.
[19] Di Mario F，Crafa P，Barchi A，et al. Pepsinogen Ⅱ in gastritis and Helicobacter pylori infection [J]. Helicobacter，2022，27（2）：e12872-e12882.
[20] 高宇飞，李国熊，方家恒，等.阿司匹林对胃黏膜癌前变化患者胃血清学活组织检查影响的临床研究[J].中华消化杂志，2020，40（11）：778-781.
[21] Lee MW，Katz PO. Nonsteroidal Antiinflammatory Drugs，Anticoagulation，and Upper Gastrointestinal Bleeding [J]. Clin Geriatr Med，2021，37（1）：31-42.
[22] Shin S，Lee SH，Lee M，et al. Aspirin and the risk of hepatocellular carcinoma development in patients with alcoholic cirrhosis [J]. Medicine （Baltimore），2020，99（9）：e19008- e19018.
[23] Zhang M，Liu D，Wang Q，et al. Gastrointestinal bleeding in patients admitted to cardiology：risk factors and a new risk score [J]. Hellenic J Cardiol，2021，62（4）：291-296.
[24] 陈金，马建霞，于晓峰，等.老年人非甾体抗炎药相关性上消化道出血的临床特点[J].中国临床药学杂志，2020， 29（3）：177-181.
[25] 邓园园，黄应文，熊红，等.非甾体类抗炎药相关性上消化道出血的危险因素及凝血相关指标分析[J].实用临床医药杂志，2022，26（7）：13-17，21. |
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