Anthony A, Dhillon A P, Sim R, Nygard G, Pounder R E, Wakefield A J
University Department of Histopathology, Royal Free Hospital School of Medicine, London, UK.
Aliment Pharmacol Ther. 1994 Aug;8(4):417-24. doi: 10.1111/j.1365-2036.1994.tb00309.x.
Patients on nonsteroidal anti-inflammatory drugs can develop curious intestinal fibrotic diaphragms.
Groups of rats received indomethacin mixed into a powdered diet at 3 mg.kg/day for 6 and 12 weeks and 6 mg.kg/day for up to 6 weeks. In an attempt to reproduce a human dosing regimen, another group of rats, for a total of 30 weeks, received consecutive periods of indomethacin at 3 mg.kg/day for 12 weeks, 4.5 mg.kg/day for 1 week, 6 mg.kg/day for 1 week, control diet for 6 weeks, 4.5 mg.kg/day for 2 weeks and finally, a control diet for a healing period of 8 weeks. Control rats received powdered diet alone. At termination, the small and large intestines were examined macroscopically and histologically.
Indomethacin caused microcytic anaemia, hypoalbuminaemia, small intestinal ulceration, caecal ulceration and inconspicuous raised mucosal lesions in the caecum that histologically showed submucosal fibrosis with disruption and thickening of the apical muscularis mucosae. No control rats showed any abnormality.
These fibrotic lesions of the rat caecum resemble human diaphragms and may arise from healed caecal ulcers.
服用非甾体抗炎药的患者可能会出现奇特的肠道纤维化隔膜。
将大鼠分为几组，分别给予掺入吲哚美辛的粉状饲料，剂量为3毫克/千克/天，持续6周和12周，以及6毫克/千克/天，持续6周。为了模拟人类给药方案，另一组大鼠共30周，依次接受以下给药周期：3毫克/千克/天的吲哚美辛，持续12周；4.5毫克/千克/天，持续1周；6毫克/千克/天，持续1周；对照饲料，持续6周；4.5毫克/千克/天，持续2周；最后是对照饲料，持续8周的愈合期。对照大鼠仅给予粉状饲料。处死时，对小肠和大肠进行宏观和组织学检查。
吲哚美辛导致小细胞性贫血、低白蛋白血症、小肠溃疡、盲肠溃疡以及盲肠黏膜隆起性病变不明显，组织学显示黏膜下纤维化伴顶端黏膜肌层中断和增厚。对照大鼠未出现任何异常。
大鼠盲肠的这些纤维化病变类似于人类的隔膜，可能源于愈合的盲肠溃疡。
