Levine R A, Petokas S, Nandi J, Enthoven D
Department of Medicine, State University of New York Health Science Center, Syracuse.
Dig Dis Sci. 1988 Jun;33(6):660-6. doi: 10.1007/BF01540427.
A new nonsteroidal, antiinflammatory drug, carprofen, was compared with indomethacin as to their effects on mucosal injury and prostanoid biosynthesis. A prospective, double-blind endoscopy study was performed in 40 healthy adults. After baseline normal endoscopy, 20 subjects were randomly assigned to either indomethacin (25 mg four times daily) or carprofen (150 mg twice daily) for eight days and re-endoscoped. Urinary and gastric mucosal prostaglandin generation, respectively, of PGE2 and PGF2 alpha, and PGE and 6-keto-PGF1 alpha was determined. Minor subjective symptoms occurred in six of 20 indomethacin (including four of eight with gastrointestinal injury) and in three of 20 carprofen subjects. Indomethacin and carprofen reduced gastric and urinary prostaglandin synthesis to a similar degree. Gastrointestinal injury was present in eight of 20 indomethacin and in none of 20 carprofen subjects. This study fails to establish a relationship between duodenal mucosal lesions and gastric prostanoid generation and confirms the lack of correlation between indomethacin-induced duodenal injury and subjective symptomatology. Carprofen appears to produce less objective damage in the upper gastrointestinal tract than indomethacin at comparable clinical doses.
一种新型非甾体抗炎药卡洛芬与吲哚美辛就其对黏膜损伤和前列腺素生物合成的影响进行了比较。对40名健康成年人进行了一项前瞻性双盲内镜研究。在基线内镜检查正常后，20名受试者被随机分配接受吲哚美辛（每日4次，每次25毫克）或卡洛芬（每日2次，每次150毫克）治疗8天，然后再次进行内镜检查。分别测定尿液和胃黏膜中前列腺素E2、前列腺素F2α、前列腺素E和6-酮-前列腺素F1α的生成情况。20名服用吲哚美辛的受试者中有6人出现轻微主观症状（包括8名有胃肠道损伤者中的4人），20名服用卡洛芬的受试者中有3人出现轻微主观症状。吲哚美辛和卡洛芬对胃和尿液中前列腺素合成的降低程度相似。20名服用吲哚美辛的受试者中有8人出现胃肠道损伤，而20名服用卡洛芬的受试者中无人出现胃肠道损伤。本研究未能证实十二指肠黏膜病变与胃前列腺素生成之间的关系，并确认吲哚美辛所致十二指肠损伤与主观症状之间缺乏相关性。在相当的临床剂量下，卡洛芬对上消化道造成的客观损害似乎比吲哚美辛少。
