Department of Pediatrics, Division of Rheumatology, Medical College of Wisconsin, Children's Research Institute, Milwaukee, WI, USA.
Pediatr Rheumatol Online J. 2010 Apr 14;8:11. doi: 10.1186/1546-0096-8-11.
No consensus evidence-based guidelines for the routine laboratory monitoring of children with JIA receiving non-steroidal anti-inflammatory drugs (NSAIDs) exist. The purpose of this study is to evaluate the clinical utility of routine laboratory monitoring of hemoglobin, transaminases, blood urea nitrogen, serum creatinine, and urinalysis in patients with juvenile idiopathic arthritis (JIA) receiving NSAIDs.
The medical records of 91 children with JIA followed between 1996 and 2006 were retrospectively reviewed for laboratory results and clinically significant adverse effects attributed to NSAID use. Laboratory abnormalities were documented, with potential adverse clinical sequelae, including if NSAID use was discontinued.
Abnormal laboratory results were recorded for 24 of 91 patients. Nearly all abnormalities were mild and not associated with adverse clinical sequelae. All patients but one continued to receive NSAID therapy after the abnormality was detected.
Although detection of abnormal laboratory values occurred while on NSAIDs, these abnormalities did not correlate with adverse clinical signs and symptoms. The routine monitoring of laboratory tests in asymptomatic children treated with NSAIDs is of questionable utility.
目前尚无针对接受非甾体抗炎药（NSAIDs）治疗的幼年特发性关节炎（JIA）儿童进行常规实验室监测的循证指南。本研究旨在评估对接受 NSAIDs 治疗的 JIA 患者进行常规血红蛋白、转氨酶、血尿素氮、血清肌酐和尿液分析检测的临床实用性。
回顾性分析了 1996 年至 2006 年间接受 NSAIDs 治疗的 91 例 JIA 患儿的病历，以评估实验室结果和与 NSAID 使用相关的临床显著不良事件。记录实验室异常情况，并记录潜在的不良临床后果，包括是否停用 NSAID。
91 例患者中有 24 例记录了实验室异常。几乎所有的异常都很轻微，且与不良的临床后果无关。所有患者在发现异常后均继续接受 NSAID 治疗。
尽管在使用 NSAIDs 时检测到了异常的实验室值，但这些异常与不良的临床体征和症状并无相关性。对接受 NSAIDs 治疗的无症状儿童进行常规实验室检测的实用性值得怀疑。
