Ishioka T
Edogawa Hospital, Takasago Branch, Tokyo.
Drugs. 1988;35 Suppl 1:95-100. doi: 10.2165/00003495-198800351-00022.
In a study of the effects of various NSAIDs on renal function in the elderly, indomethacin, tiaprofenic acid and sulindac were administered to patients ranging in age from 54 to 97 years for a period of 3 months. Indomethacin sustained release (25 mg tid) was administered to 66 patients, tiaprofenic acid (200 mg tid) to 54 patients, and sulindac (100 mg tid) to 59 patients. A control group, to whom no NSAIDs were administered, comprised 60 patients. Renal function before and after NSAID administration was compared, the parameters investigated being blood urea nitrogen (BUN), serum creatinine (SCR), and serum beta 2-microglobulin (beta 2-m) concentrations. Patients whose levels of BUN, SCR and beta 2-microglobulin were all within normal ranges at the beginning of the study were considered to have 'normal' renal function; those who showed an abnormal value for at least 1 of the 3 parameters were considered to have 'abnormal' renal function. The administration of indomethacin resulted in a significant increase in the serum creatinine concentration, and in the normal renal function subgroup, a significant increase in BUN. Sulindac administration resulted in a significant increase in BUN and beta 2-microglobulin concentrations, but no significant change in serum creatinine. In comparison, the administration of tiaprofenic acid resulted in no significant changes in any of 3 parameters. An additional study of the effects of 4 weeks' administration of the same NSAIDs on N-acetyl-beta-D-glucosaminidase concentrations in the urine of elderly patients revealed no significant changes with any of the 3 drugs. This suggests that the drugs do not damage the proximal tubules.
在一项关于各种非甾体抗炎药（NSAIDs）对老年人肾功能影响的研究中，对年龄在54至97岁的患者给予吲哚美辛、噻洛芬酸和舒林酸，为期3个月。对66例患者给予缓释吲哚美辛（25mg，每日3次），54例患者给予噻洛芬酸（200mg，每日3次），59例患者给予舒林酸（100mg，每日3次）。未给予NSAIDs的60例患者组成对照组。比较了给予NSAIDs前后的肾功能，研究的参数包括血尿素氮（BUN）、血清肌酐（SCR）和血清β2-微球蛋白（β2-m）浓度。在研究开始时BUN、SCR和β2-微球蛋白水平均在正常范围内的患者被认为肾功能“正常”；这3项参数中至少有1项值异常的患者被认为肾功能“异常”。给予吲哚美辛导致血清肌酐浓度显著升高，在肾功能正常的亚组中，BUN也显著升高。给予舒林酸导致BUN和β2-微球蛋白浓度显著升高，但血清肌酐无显著变化。相比之下，给予噻洛芬酸后这3项参数均无显著变化。另一项关于相同NSAIDs给药4周对老年患者尿中N-乙酰-β-D-葡萄糖苷酶浓度影响的研究表明，这3种药物均未引起显著变化。这表明这些药物不会损害近端肾小管。
