Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7 Keunjaebong-gil, Hwaseong, 18450, Korea.
Dig Dis Sci. 2021 Aug;66(8):2724-2731. doi: 10.1007/s10620-020-06511-z. Epub 2020 Aug 3.
Currently, because the population is aging, use of medications has been increasing, including use of nonsteroidal anti-inflammatory drugs (NSAIDs) and antithrombotic agents.
This study aims to investigate whether NSAIDs can cause damage to the small bowel (SB) mucosa.
Endoscopic videos of subjects who had undergone capsule endoscopy (CE) were evaluated by three experts in order to identify SB injury. All medications taken within 2 weeks from the time of CE were investigated. Cases with a final diagnosis of intestinal tuberculosis, inflammatory bowel disease, Behcet's disease, Peutz-Jeghers syndrome, small bowel lymphoma, or Henoch-Schönlein purpura were excluded from the analysis.
Among the 273 subjects, 125 (45.8%) had SB erosions or ulcers (erosion group) and the remaining 148 (54.2%) did not (no erosion group). SB erosions or ulcers were more common in females, patients aged > 60 years, and subjects taking NSAIDs (p = 0.048, 0.032, and < 0.001, respectively). No statistically significant differences were found between the two groups in the following variables: history of cancer and GI surgery, reasons for the test, comorbidities, and use of anticoagulants and antiplatelet agents. Multivariate analysis showed that use of NSAIDs [OR 4.191 (95% CI 1.858-9.458), p < 0.001] was an independent risk factor for SB erosions or ulcers.
Use of NSAIDs is the only independent risk factor for SB injury identified in this study. Antithrombotic agents do not cause or exacerbate damage to the SB, according to our results.
KCT0004795.
目前，由于人口老龄化，药物的使用量不断增加，包括非甾体抗炎药（NSAIDs）和抗血栓药物的使用。
本研究旨在探讨 NSAIDs 是否会导致小肠（SB）黏膜损伤。
对接受胶囊内镜（CE）检查的患者的内镜视频进行了三位专家的评估，以识别 SB 损伤。调查了在 CE 进行时间的 2 周内服用的所有药物。将肠结核、炎症性肠病、白塞病、Peutz-Jeghers 综合征、小肠淋巴瘤或过敏性紫癜的病例排除在分析之外。
在 273 名患者中，125 名（45.8%）存在 SB 糜烂或溃疡（糜烂组），其余 148 名（54.2%）没有（无糜烂组）。SB 糜烂或溃疡在女性、年龄 > 60 岁的患者和服用 NSAIDs 的患者中更为常见（p = 0.048、0.032 和 < 0.001）。在两组之间，以下变量无统计学差异：癌症和胃肠道手术史、检查原因、合并症以及抗凝和抗血小板药物的使用。多变量分析显示，使用 NSAIDs [比值比（OR）4.191（95%置信区间 1.858-9.458），p < 0.001]是 SB 糜烂或溃疡的独立危险因素。
根据本研究结果，使用 NSAIDs 是唯一确定的 SB 损伤的独立危险因素。抗血栓药物不会导致或加重 SB 损伤。
KCT0004795。
