Bjarnason I, Zanelli G, Smith T, Prouse P, Williams P, Smethurst P, Delacey G, Gumpel M J, Levi A J
Gastroenterology. 1987 Sep;93(3):480-9. doi: 10.1016/0016-5085(87)90909-7.
This study examines the effects of nonsteroidal antiinflammatory drugs on the small intestine in humans. Using an 111In-leukocyte technique in patients with rheumatoid arthritis (n = 90) and osteoarthritis (n = 7), it appears that nonsteroidal antiinflammatory drugs cause small intestinal inflammation in two-thirds of patients on long-term treatment and on discontinuation, the inflammation may persist for up to 16 mo. The prevalence and magnitude of the intestinal inflammation was unrelated to the type and dose of nonsteroidal drugs and previous or concomitant second-line drug treatment. There was a significant inverse correlation (r = -0.29, p less than 0.05) between fecal 111In excretion and hemoglobin levels in patients treated with nonsteroidal antiinflammatory drugs. The kinetics of fecal indium 111 excretion in patients treated with nonsteroidal antiinflammatory drugs was almost identical to that of patients with small bowel Crohn's disease. Eighteen patients on nonsteroidal antiinflammatory drugs underwent a radiologic examination of the small bowel and 3 were found to have asymptomatic ileal disease with ulceration and strictures. Nineteen patients on nonsteroidal antiinflammatory drugs, 20 healthy controls, and 13 patients with Crohn's ileitis underwent a dual radioisotopic ileal function test with tauro 23 (75Se) selena-25-homocholic acid and cobalt 58-labeled cyanocobalamine. On day 4, more than half of the patients with rheumatoid arthritis had evidence of bile acid malabsorption, but the ileal dysfunction was much milder than seen in patients with Crohn's ileitis.
本研究探讨了非甾体抗炎药对人体小肠的影响。对类风湿关节炎患者（n = 90）和骨关节炎患者（n = 7）采用铟 - 111标记白细胞技术，结果显示，在接受长期治疗的患者中，三分之二的患者非甾体抗炎药会导致小肠炎症，且停药后，炎症可能持续长达16个月。肠道炎症的发生率和严重程度与非甾体药物的类型和剂量以及既往或同时使用的二线药物治疗无关。在接受非甾体抗炎药治疗的患者中，粪便铟 - 111排泄量与血红蛋白水平之间存在显著负相关（r = -0.29，p < 0.05）。接受非甾体抗炎药治疗的患者粪便铟 - 111排泄动力学与小肠克罗恩病患者几乎相同。18例接受非甾体抗炎药治疗的患者接受了小肠放射学检查，其中3例被发现患有无症状性回肠疾病，伴有溃疡和狭窄。19例接受非甾体抗炎药治疗的患者、20例健康对照者以及13例克罗恩回肠炎患者接受了用牛磺 - 23（75硒）硒代 - 25 - 高胆酸和钴 - 58标记的氰钴胺进行的双放射性同位素回肠功能试验。在第4天，超过一半的类风湿关节炎患者有胆汁酸吸收不良的证据，但回肠功能障碍比克罗恩回肠炎患者轻得多。
