Association of long-term use of low-dose aspirin with Helicobacter pylori infection and effect on recurrence rate

长期服用低剂量阿司匹林与幽门螺杆菌感染的关联及其对复发率的影响

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Abstract

To investigate the relationship between long-term use of low-dose aspirin and Helicobacter pylori (HP) infection, and its effect on eradication and recurrence of HP. According to the results of C(14)-Urea Breath Test (C(14)-UBT), 3256 patients with cardiovascular and cerebrovascular diseases from March 2019 to December 2020, were divided into HP infection group and non-infection group. Univariate and multivariate was used to investigate the relationship between Low-dose aspirin use and HP infection. 859 patients with hypertension combined with HP infection were divided into aspirin group, non-aspirin group and control group, the eradication rate after 2 weeks of bismuth-containing quadruple drug treatment and the recurrence rate after 1,3 year were compared. The overall infection rate of HP was 53.3%. The results of univariate analysis showed that the infection rate of female, age, BMI, LDL-C, FBG of HP infected group was higher than non-infection. The infection rate of patients who took low-dose aspirin was higher than no-aspirin [56.6% vs. 51.3%, χ(2) = 8.548, P = 0.003]. Multivariate Logistic regression analysis showed that long-term aspirin use still increased the risk of infection (OR = 1.433, 95% CI 1.196-1.947, P < 0.001). The Per-Protocol analysis showed that the overall eradication rate was 87.6%, and among the eradication rates of aspirin group, non-aspirin group and control group were not statistically significantly (87.8%, 88.5%, and 86.6%, respectively), The Intention-To-Treat analysis showed that the overall eradication rate was 84.3%, and the eradication rates among the three groups were not statistically significantly. The overall 1-year recurrence rate was 1.3%, and the recurrence rates of the three groups were no statistical significance. The overall 3-years recurrence rate was 3.1%, and the recurrence rate of aspirin group was higher than non-aspirin group and control group (5.30%, 1.90% and 1.70%, respectively, χ(2) = 6.118, P < 0.05). The main adverse reactions in the first month of eradication treatment were constipation and mild nausea, and there was no statistical significance between the three groups. Long-term use of low-dose aspirin increases the risk of HP infection and the recurrence rate in 3 years after eradication. It is suggested that HP should be tested and eradicated regularly in long-term users.

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