Swift G L, Arnold J, Williams G T, Williams B D, Rhodes J, Khan F
Department of Gastroenterology, University Hospital of Wales, Cardiff, UK.
Digestion. 1992;53(1-2):88-93. doi: 10.1159/000200975.
Twenty patients taking long-term indomethacin were chosen for the study because all had a normal endoscopic examination; biopsies, however, from the oesophagus, gastric antrum and duodenal bulb revealed histological inflammation in all patients in at least one site. After 8 weeks during which indomethacin therapy was continued, a further endoscopy revealed lesions in 5 patients--peptic ulcer in 3 and erosions in 2--but only 1 of these had any change in gastro-intestinal symptoms. Irrespective of whether mucosal lesions are seen on endoscopy in patients established on non-steroidal anti-inflammatory drug therapy, they remain in danger of developing both ulcers and erosions which are likely to be asymptomatic. At no time can one justifiably feel this patient group is not at risk of peptic ulceration.
20名长期服用吲哚美辛的患者被选入该研究，因为他们所有人的内镜检查结果均正常；然而，对食管、胃窦和十二指肠球部进行活检发现，所有患者至少在一个部位存在组织学炎症。在继续使用吲哚美辛治疗的8周后，再次进行内镜检查发现5名患者出现病变——3名患者出现消化性溃疡，2名患者出现糜烂——但其中只有1名患者的胃肠道症状有任何变化。无论在接受非甾体抗炎药治疗的患者中内镜检查是否发现黏膜病变，他们都仍有发生溃疡和糜烂的风险，而这些病变可能没有症状。任何时候都不能合理地认为这个患者群体没有消化性溃疡的风险。
