Hernandez Avila M, Walker A M, Romieu I, Spiegelman D L, Perera D R, Jick H
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
Lancet. 1988 Sep 3;2(8610):556-9. doi: 10.1016/s0140-6736(88)92670-0.
Prior use of analgesics among 1327 new users of cimetidine over the age of 65 at Group Health Cooperative of Puget Sound was much more common than among 5308 members of similar age and sex who had never taken cimetidine. The excess included not only most non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin, but also extended to paracetamol. New users of cimetidine who had not received analgesics in the preceding 2 years were preferentially given recently introduced NSAIDs if an NSAID was subsequently prescribed. Review of prior studies of analgesic use and ulcer diseases reveals a regular association between ulcer and preceding use of paracetamol, a drug for which no causal association to ulcer is thought to exist. General increases in use of analgesics by elderly dyspeptic patients may have given rise to artefact in reported associations between manifestations of ulcer disease and NSAIDs.
在普吉特海湾卫生合作组织中，1327名65岁以上新使用西咪替丁的患者中，镇痛药的先前使用情况比5308名年龄和性别相仿但从未服用过西咪替丁的成员更为普遍。这种过量使用不仅包括大多数非甾体抗炎药（NSAIDs）和阿司匹林，还扩展到了对乙酰氨基酚。在过去2年未接受过镇痛药治疗的西咪替丁新使用者，如果随后开具了NSAIDs处方，则优先给予最近推出的NSAIDs。对先前镇痛药使用和溃疡疾病研究的回顾表明，溃疡与先前使用对乙酰氨基酚之间存在规律关联，而对乙酰氨基酚被认为与溃疡不存在因果关系。老年消化不良患者镇痛药使用的普遍增加可能导致了溃疡疾病表现与NSAIDs之间报告关联中的假象。
