Kanik Emine Arzu, Canbaz Hakan, Colak Tahsin, Aydin Suha
Department of Biostatistics, Mersin University, Mersin, Turkey.
Department of General Surgery, Mersin University, Mersin, Turkey.
Curr Ther Res Clin Exp. 2004 Jul;65(4):345-52. doi: 10.1016/j.curtheres.2004.06.001.
Although many experimental, epidemiologic, and clinical studies have suggested that aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in reducing and preventing colorectal adenomas, randomized, controlled trials (RCTs) are still being carried out to obtain statistically reliable results.
The aim of this meta-analysis was to review long-term, prospective RCTs investigating the effect of NSAIDs on the relative risk (RR) for developing ≥1 new colorectal polyp or adenoma in a high-risk population.
We conducted a comprehensive search of MEDLINE, PubMed, and other electronic databases (including Inter-Science, Science Direct, Ebsco, Synergy, and Proquest) (key terms: nonsteroidal anti-inflammatory drugs, aspirin, colorectal, and polyps; years: 1974-2004) for English-language articles. Eligible studies were analyzed in terms of demographic data, adverse effects, and effect of NSAIDs on the RRs.
Four long-term, prospective RCTs were used in the statistical analysis. A total of 2069 high-risk patients were enrolled; 1880 patients completed the studies, and 1127 were in active-treatment groups (aspirin 81-325 mg/d or sulindac 150-300 mg/d). Our meta-analysis of these studies revealed that the overall RR for developing ≥ 1 new colorectal polyp or adenoma was significantly reduced by using aspirin or other NSAIDs (RR = 0.809; 95% CI, 0.718-0.912).
The results of this meta-analysis suggest that regular use of aspirin 81 to 325 mg/d or sulindac 150 to 300 mg/d for ≥1 year was associated with a decrease in the RR for developing ≥ 1 new colorectal polyp or adenoma to 0.80 (95% CI, 0.718-0.912) in patients at high risk.
尽管许多实验、流行病学和临床研究表明阿司匹林或其他非甾体抗炎药（NSAIDs）在减少和预防结直肠腺瘤方面有效，但仍在进行随机对照试验（RCT）以获得统计学上可靠的结果。
本荟萃分析的目的是回顾长期前瞻性RCT，研究NSAIDs对高危人群发生≥1个新的结直肠息肉或腺瘤的相对风险（RR）的影响。
我们全面检索了MEDLINE、PubMed和其他电子数据库（包括Inter-Science、Science Direct、Ebsco、Synergy和Proquest）（关键词：非甾体抗炎药、阿司匹林、结直肠和息肉；年份：1974 - 2004年）以查找英文文章。对符合条件的研究从人口统计学数据、不良反应以及NSAIDs对RR的影响方面进行分析。
四项长期前瞻性RCT用于统计分析。共纳入2069例高危患者；1880例患者完成研究，其中1127例在积极治疗组（阿司匹林81 - 325 mg/d或舒林酸150 - 300 mg/d）。我们对这些研究的荟萃分析显示，使用阿司匹林或其他NSAIDs可使发生≥1个新的结直肠息肉或腺瘤的总体RR显著降低（RR = 0.809；95%CI，0.718 - 0.912）。
本荟萃分析结果表明，高危患者连续≥1年规律使用81至325 mg/d阿司匹林或150至300 mg/d舒林酸与将发生≥1个新的结直肠息肉或腺瘤的RR降至0.80（95%CI，0.718 - 0.912）相关。
