Dowd J E, Cimaz R, Fink C W
University of Texas Southwestern Medical Center, Dallas, USA.
Arthritis Rheum. 1995 Sep;38(9):1225-31. doi: 10.1002/art.1780380908.
To determine the incidence of abdominal pain and gastroduodenal injury in children with arthritis taking nonsteroidal antiinflammatory drugs (NSAIDs).
A retrospective review of the records of all children (570 patients) receiving followup care in an academic rheumatology clinic between 1991 and 1993 was performed.
There were 344 patients who used NSAIDs during the study period. Abdominal pain was recorded in 27.9% of patients taking NSAIDs and 14.6% of patients not taking NSAIDs. Abdominal pain in 47 patients (49%) taking NSAIDs and 14 patients (42%) not taking NSAIDs was evaluated radiographically and/or endoscopically. Among those patients evaluated, gastric or duodenal injury was found in 16 (34.0%) who were taking NSAIDs and 1 (7.1%) who were not. This represented a relative risk for gastroduodenal injury of 4.8 for patients taking NSAIDs (P = 0.09). The incidence of injury did not change when analyses were controlled for prednisone or slow-acting antirheumatic drug use. None of the children were hospitalized or died as a result of gastroduodenal injury during the 3-year period.
We conclude that NSAID use in children with arthritis frequently leads to gastroduodenal injury, with an estimated incidence and relative risk that are comparable to the rates found in adults with arthritis taking NSAIDs, but that hospitalization or death as a result of this injury is uncommon.
确定服用非甾体抗炎药（NSAIDs）的关节炎患儿腹痛及胃十二指肠损伤的发生率。
对1991年至1993年间在一家学术性风湿病诊所接受随访的所有儿童（570例患者）的记录进行回顾性研究。
在研究期间有344例患者使用了NSAIDs。服用NSAIDs的患者中有27.9%记录有腹痛，未服用NSAIDs的患者中有14.6%记录有腹痛。对47例（49%）服用NSAIDs和14例（42%）未服用NSAIDs的腹痛患者进行了影像学和/或内镜检查。在这些接受检查的患者中，服用NSAIDs的患者有16例（34.0%）发现有胃或十二指肠损伤，未服用NSAIDs的患者有1例（7.1%）发现有胃或十二指肠损伤。这表明服用NSAIDs的患者发生胃十二指肠损伤的相对风险为4.8（P = 0.09）。在对泼尼松或慢作用抗风湿药的使用进行分析控制后，损伤发生率没有变化。在这3年期间，没有儿童因胃十二指肠损伤而住院或死亡。
我们得出结论，关节炎患儿使用NSAIDs常导致胃十二指肠损伤，其估计发生率和相对风险与服用NSAIDs的成年关节炎患者的发生率相当，但因这种损伤而住院或死亡的情况并不常见。
