Savage R L, Moller P W, Ballantyne C L, Wells J E
Department of Medicine, Christchurch School of Medicine, New Zealand.
Arthritis Rheum. 1993 Jan;36(1):84-90. doi: 10.1002/art.1780360114.
To assess the risk of perforation or hemorrhage of peptic ulcer on treatment with nonsteroidal antiinflammatory drugs (NSAIDs), both as a class and as individual agents.
A case-control study of medication histories in 494 patients and 972 matched control subjects.
The increase in risk (odds ratio) with NSAID therapy was 5.1 times the risk in controls. The odds ratio for piroxicam was 6.3 (95% confidence interval [CI] 3.3-12.0), as compared with 2.9 for diclofenac, ketoprofen, and sulindac combined (95% CI 2.0-4.2). The effect of other risk factors was also considered, and the adjusted odds ratios were 4.1 for all NSAIDs, 6.4 (95% CI 2.8-15.0) for piroxicam, and 3.3 (95% CI 2.0-5.5) for diclofenac, ketoprofen, and sulindac combined.
The estimate of overall risk of peptic ulcer complications with NSAIDs is similar to that found in other studies. There appear to be differences in risk between agents.
评估使用非甾体抗炎药（NSAIDs）进行治疗时，消化性溃疡发生穿孔或出血的风险，包括NSAIDs这一类药物以及其中的各个药物。
对494例患者和972例匹配的对照受试者的用药史进行病例对照研究。
NSAIDs治疗导致的风险增加（比值比）是对照组风险的5.1倍。吡罗昔康的比值比为6.3（95%置信区间[CI] 3.3 - 12.0），而双氯芬酸、酮洛芬和舒林酸联合使用时的比值比为2.9（95% CI 2.0 - 4.2）。还考虑了其他风险因素的影响，所有NSAIDs调整后的比值比为4.1，吡罗昔康为6.4（95% CI 2.8 - 15.0），双氯芬酸、酮洛芬和舒林酸联合使用时为3.3（95% CI 2.0 - 5.5）。
NSAIDs导致消化性溃疡并发症的总体风险评估与其他研究结果相似。不同药物之间的风险似乎存在差异。
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