@article{
author = "Smolović, Brigita and Stanisavljević, Dejana and Golubović, Mileta and Vučković, Ljiljana and Miličić, Biljana and Đuranović, Srđan",
year = "2014",
abstract = "Background/Aim. A high risk of bleeding in Helicobacter pylori (H.pylori)-negative, non-steroidal anti-inflammatory drugs (NSAID)-negative ulcers highlights the clinical importance of analysis of the changing trends of peptic ulcer disease. The aim of the study was to investigate the risk factors for ulcer bleeding in patients with non-H. pylori infection, and with no NSAIDs use. Methods. A prospective study included patients with endoscopically diagnosed ulcer disease. The patients were without H. pylori infection (verified by pathohistology and serology) and without exposure to NSAIDs and proton pump inhibitors (PPI) within 4 weeks before endoscopy. After endoscopy the patients were divided into 2 groups: the study group of 48 patients with bleeding ulcer and the control group of 47 patients with ulcer, but with no bleeding. Prior to endoscopy they had completed a questionnaire about demographics, risk factors and habits. The platelet function, von Willebrand factor (vWF) and blood groups were determined. Histopathological analysis of biopsy samples were performed with a modified Sydney system. The influence of bile reflux was analyzed by Bile reflux index (BRI). Results. Age, gender, tobacco and alcohol use did not affect the bleeding rate. The risk of bleeding did not depend on concomitant diseases (p = 0.509) and exposure to stress (p = 0.944). Aspirin was used by 16/48 (33.3%) patients with bleeding ulcer, as opposed to 7/47 (14.9%) patients who did not bleed (p = 0.036). Abnormal platelet function had 12/48 (25.0%) patients who bled, as opposed to 2/47 (4.3%) patients who did not bleed (p = 0.004). Patients with BRI lt 14 bled in 79.2%, and did not bleed in 57.4% of the cases (p = 0.023). There was no statistical difference between groups in regards to blood groups and range of vWF. Antrum atrophy was found in 14/48 (29.2%) patients with bleeding ulcer and in only 5/47 (10.6%) patients who had ulcer without bleeding (p = 0.024). Conclusion. Abnormal platelet function, aspirin use and antrum atrophy were the risk factors for ulcer bleeding in non-H. pylori, non- NSAIDs ulcer disease., Uvod/Cilj. Visoki rizik od krvarenja Helicobacter pylori (H. pylori)-negativnih i sa nesteroidnim inflamatornim lekovima (NSAIL)-negativnih ulkusa potencirao je klinički značaj analiziranja novih tendencija peptičke ulkusne bolesti. Cilj ove studije bio je ispitati faktore rizika od nastanka krvarećeg ulkusa kod bolesnika bez H. pylori infekcije i bez upotrebe NSAIL. Metode. Prospektivna studija obuhvatala je bolesnike sa endoskopski dijagnostikovanom ulkusnom bolešću. Bolesnici su bili bez H. pylori infekcije (potvrđeno patohistološki i serološki) i bez upotrebe NSAIL i inhibitora protonske pumpe (IPP) tokom četiri nedelje pre endoskopije. Posle endoskopije bolesnici su bili podeljeni u dve grupe: studijsku grupu od 48 bolesnika sa krvarećim ulkusom i kontrolnu grupu od 47 bolesnika sa ulkusom bez krvarenja. Pre endoskopije bolesnici su popunjavali upitnik o demografskim podacima, faktorima rizika i navikama. Funkcija trombocita, von Willebrand faktor (vWF) i krvne grupe ispitivane su, takođe. Patohistološki su analizirani biopsijski uzorci po modifikovanom Sydnejskom sistemu. Uticaj bilijarnog refluksa analiziran je pomoću bilijarnog refluksnog indeksa (BRI). Rezultati. Godine, pol, pušenje i upotreba alkohola nisu imali uticaj na stopu krvarenja. Rizik od krvarenja nije zavisio od udruženih bolesti (p = 0,509), niti od izloženosti stresu (p = 0,944). Aspirin je uzimalo 16/48 (33,3%) bolesnika sa krvarećim ulkusom, u poredeđenju sa 7/47 (14.9%) bolesnika koji nisu krvarili (p = 0,036). Abnormalnu funkciju trombocita imalo je 12/48 (25,0%) bolesnika sa krvarenjem, u poređenju sa 2/47 (4,3%) bolesnika koji nisu krvarili (p = 0,004). Bolesnici sa BRI lt 14 krvarili su u 79,2%, a nisu krvarili u 57,4% slučajeva (p = 0,023). Nije bilo statistički značajne razlike između dve grupe u odnosu na krvne grupe i nivo vWF. Antralna atrofija nađena je kod 14/48 (29,2%) bolesnika sa krvarećim ulkusom i kod 5/47 (10,6%) bolesnika koji su imali ulkus bez krvarenja (p = 0,024). Zaključak. Abnormalna funkcija trombocita, upotreba aspirina i antralna atrofija jesu faktori rizika od krvarenja kod H. pylori-negativne i NSAIL-negativne ulkusne bolesti.",
publisher = "Vojnomedicinska akademija - Institut za naučne informacije, Beograd",
journal = "Vojnosanitetski pregled",
title = "Bleeding gastroduodenal ulcers in patients without Helicobacter pylori infection and without exposure to non-steroidal anti-inflammatory drugs, Krvareći gastroduodenalni ulkusi kod bolesnika bez Helicobacter pylori infekcije i bez upotrebe nesteroidnih antiinflamatornih lekova",
volume = "71",
number = "2",
pages = "183-190",
doi = "10.2298/VSP1402183S"
}
