Larkai E N, Smith J L, Lidsky M D, Sessoms S L, Graham D Y
Department of Medicine, Veterans Administration Medical Center, Houston, Texas 77030.
J Clin Gastroenterol. 1989 Apr;11(2):158-62. doi: 10.1097/00004836-198904000-00009.
Gastroduodenal intolerance is one of the major factors limiting the use of aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) in patients with rheumatic diseases. We previously demonstrated that dyspepsia was not a marker for ulcer in NSAID users. We have now evaluated dyspeptic symptoms in 245 arthritic patients (receiving 13 different NSAIDs) from the practices of two rheumatologists. Fifty-seven patients (23%) gave a history of previous peptic ulcers. Heartburn, indigestion, or sour stomach at least once within the past year was present in 62.5%; 36.7% had experienced these symptoms within the previous 2 months and 28.6% within the previous week. Only 39 patients (15.9%) had experienced dyspepsia more than once daily within the previous month, and 8 (3.3%) had dyspepsia greater than 5 times/day. Thirty-four of the 39 patients with daily dyspepsia claimed to obtain relief with cimetidine or antacids (34 patients) or food (2 patients), whereas 3 had not discovered anything that provided relief. Women smokers were more likely than nonsmokers to experience dyspepsia (p less than 0.001). Neither men smokers nor those with a history of previous ulcer were more likely to have dyspepsia than nonsmokers or those without a history of ulcer (p greater than 0.5). We were not able to find a statistical association between any NSAID, or combination of NSAIDs, and the frequency of dyspepsia.
胃十二指肠不耐受是限制阿司匹林和其他非甾体抗炎药（NSAIDs）在风湿病患者中使用的主要因素之一。我们之前证明，消化不良并非NSAIDs使用者溃疡的标志物。我们现在评估了来自两位风湿病专家诊所的245名关节炎患者（正在服用13种不同的NSAIDs）的消化不良症状。57名患者（23%）有消化性溃疡病史。在过去一年中至少出现过一次烧心、消化不良或胃部反酸症状的患者占62.5%；在过去2个月内出现过这些症状的患者占36.7%，在过去一周内出现过这些症状的患者占28.6%。在前一个月内，只有39名患者（15.9%）每天出现消化不良症状超过一次，8名患者（3.3%）每天出现消化不良症状超过5次。在这39名每天出现消化不良症状的患者中，34名患者称服用西咪替丁或抗酸剂（34名患者）或食物（2名患者）后症状缓解，而3名患者未发现任何能缓解症状的方法。女性吸烟者比非吸烟者更易出现消化不良症状（p<0.001）。男性吸烟者和有消化性溃疡病史的患者与非吸烟者和无消化性溃疡病史的患者相比，出现消化不良症状的可能性并无增加（p>0.5）。我们未能发现任何一种NSAIDs或NSAIDs组合与消化不良症状频率之间存在统计学关联。
