Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Ảnh hưởng của các thuốc ức chế bơm proton đối với nguy cơ chảy máu đường tiêu hóa dưới liên quan đến NSAID, aspirin, clopidogrel và warfarin
Tóm tắt
Chúng tôi đã nghiên cứu ảnh hưởng của các thuốc ức chế bơm proton (PPI) đối với chảy máu đường tiêu hóa dưới (LGIB) và sự tương tác của chúng với các thuốc chống viêm không steroid (NSAIDs), aspirin liều thấp, clopidogrel và warfarin đến nguy cơ LGIB. Chúng tôi đã tiến hành nghiên cứu một cáchProspective trên 355 bệnh nhân nhập viện khẩn cấp do LGIB và 8,221 bệnh nhân không bị chảy máu. Tất cả bệnh nhân đều được thực hiện nội soi đại tràng. Hút thuốc, uống rượu, tiếp xúc thuốc và điểm số chỉ số comorbidity Charlson đã được đánh giá trước khi thực hiện nội soi. Tỷ lệ odds đã điều chỉnh (AOR) của LGIB đã được ước tính. LGIB có mối liên hệ đáng kể với tuổi tác cao hơn, chỉ số comorbidity cao hơn và việc sử dụng NSAID, aspirin, clopidogrel hoặc warfarin. Việc sử dụng PPI có liên quan đáng kể đến tuổi tác cao hơn, giới tính nam, là người uống rượu hiện tại, chỉ số comorbidity cao hơn, và việc sử dụng NSAID, aspirin, clopidogrel, warfarin, acetaminophen, hoặc corticosteroid. Phân tích đa biến, đã điều chỉnh cho các yếu tố gây nhiễu, cho thấy LGIB không có mối liên hệ đáng kể với việc sử dụng PPI (AOR 0.87; khoảng tin cậy 95% 0.68–1.13; p = 0.311), hoặc cụ thể với omeprazole (AOR 1.18; p = 0.408), esomeprazole (AOR 0.76; p = 0.432), lansoprazole (AOR 0.93; p = 0.669), hoặc rabeprazole (AOR 0.63; p = 0.140). Trong mô hình tương tác, không phát hiện thấy tương tác đáng kể nào giữa PPI và NSAID (AOR 1.40; p = 0.293), aspirin (AOR 1.09; p = 0.767), clopidogrel (AOR 0.99; p = 0.985), hoặc warfarin (AOR 1.52; p = 0.398). Nghiên cứu bệnh–đối chứng quy mô lớn này đã chứng minh rằng việc sử dụng PPI không dẫn đến tăng nguy cơ LGIB, bất kể loại PPI được sử dụng. Hơn nữa, nguy cơ LGIB không bị ảnh hưởng bởi việc sử dụng PPI, bất kể liệu có điều trị kèm theo với NSAIDs, aspirin liều thấp, clopidogrel hoặc warfarin hay không.
Từ khóa
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