Calvet X, Gratacòs J, Font J, Larrosa M, Sanfeliu I, Roqué M
Digestive Diseases Unit, Corporació Parc Taulí, Sabadell, Barcelona, Spain.
Ann Rheum Dis. 2002 Jul;61(7):641-3. doi: 10.1136/ard.61.7.641.
The presence of dyspeptic symptoms is a common finding in patients treated with non-steroidal anti-inflammatory drugs (NSAIDs). Some studies seem to support the involvement of Helicobacter pylori infection in the dyspeptic symptoms reported by these patients, and suggest that eradication may be useful.
To determine the variables related to dyspepsia in rheumatology patients requiring NSAID treatment, assessing in particular the role of Helicobacter pylori infection.
One hundred and eighty six consecutive patients with a rheumatological disorder requiring NSAID treatment (68 male, 118 female; mean (SD) age 55 (15) years) were included in a cross sectional study; dyspeptic symptoms were measured by a previously validated scale. Helicobacter pylori infection was determined by serology. Variables related to the severity of symptoms and the need for antisecretory drugs were determined by multivariate analysis.
No relation was found between Helicobacter pylori infection and dyspepsia or any of its surrogate markers (antisecretory drug use or NSAID intolerance). Female sex and treatment with antisecretory drugs were found to be independent predictors for the appearance and severity of dyspeptic symptoms. The only independent predictive variables of the requirement for antisecretory drugs were age, previous ulcer disease, taking NSAIDs with a medium or high anti-inflammatory potential, and the symptoms score.
Helicobacter pylori infection does not seem to play any part in the gastric symptoms of patients treated long term with NSAIDs.
消化不良症状在接受非甾体抗炎药(NSAIDs)治疗的患者中很常见。一些研究似乎支持幽门螺杆菌感染与这些患者报告的消化不良症状有关,并表明根除幽门螺杆菌可能有用。
确定需要NSAIDs治疗的风湿病患者中与消化不良相关的变量,特别评估幽门螺杆菌感染的作用。
一项横断面研究纳入了186例连续的需要NSAIDs治疗的风湿病患者(男68例,女118例;平均(标准差)年龄55(15)岁);消化不良症状通过先前验证的量表进行测量。通过血清学检测幽门螺杆菌感染。通过多变量分析确定与症状严重程度和使用抗分泌药物需求相关的变量。
未发现幽门螺杆菌感染与消化不良或其任何替代指标(使用抗分泌药物或NSAIDs不耐受)之间存在关联。发现女性和使用抗分泌药物是消化不良症状出现和严重程度的独立预测因素。使用抗分泌药物需求的唯一独立预测变量是年龄、既往溃疡病、服用具有中或高抗炎潜力的NSAIDs以及症状评分。
幽门螺杆菌感染似乎在长期接受NSAIDs治疗的患者的胃部症状中不起任何作用。