El-Serag H B, Sonnenberg A
University of New Mexico, Albuquerque, USA.
Am J Gastroenterol. 1997 Jan;92(1):52-6.
It has been speculated that intake of nonsteroidal anti-inflammatory drugs (NSAIDs) represents a risk factor for the occurrence of esophagitis and esophageal strictures.
A case-control study was conducted to compare the occurrence of comorbid diseases treated with NSAIDs in case and control subjects with and without esophageal disease, respectively. The case population was comprised of all patients with esophagitis (International Classification of Diseases code 530.1) or esophageal stricture (code 530.3) who were discharged from hospitals of the Department of Veteran Affairs between 1981 and 1994. In separate multivariate logistic regressions, the occurrence of esophagitis or esophageal stricture served as the outcome variable, and age, gender, ethnicity, and comorbid occurrence of an NSAID-related diagnosis served as modifier variables.
A total of 101,366 individual case subjects were included, of whom 92,860 presented with esophagitis and 14,201 with stricture. The occurrence of erosive esophagitis was associated with osteoarthritis (odds ratio = 1.42, 95% confidence interval = 1.36-1.48), osteoporosis (1.38, 1.25-1.52), back pain (1.49, 1.42-1.56), femur bone fracture (1.46, 0.92-2.32), fibrositis (1.57, 1.41-1.75), tension headache (1.34, 1.27-1.40), ankylosing spondylitis (1.33, 1.24-1.42), rheumatoid arthritis (1.13, 1.05-1.21), sicca syndrome (1.15, 1.05-1.26), and systemic sclerosis (6.16, 4.65-8.14). NSAID-related diagnoses represented similar risk factors for both esophagitis and esophageal stricture.
A large variety of diseases treated by NSAIDs are associated with a significantly increased risk of esophageal erosion or stricture; the risk appears similar for both of these. In some comorbid conditions, the underlying disease process may contribute to the occurrence of esophageal pathology.
据推测，非甾体抗炎药（NSAIDs）的摄入是食管炎和食管狭窄发生的一个危险因素。
进行了一项病例对照研究，以比较分别患有和未患有食管疾病的病例组和对照组中接受NSAIDs治疗的合并疾病的发生情况。病例人群包括1981年至1994年间从退伍军人事务部医院出院的所有食管炎患者（国际疾病分类代码530.1）或食管狭窄患者（代码530.3）。在单独的多变量逻辑回归分析中，食管炎或食管狭窄的发生作为结果变量，年龄、性别、种族以及与NSAIDs相关诊断的合并发生情况作为修饰变量。
总共纳入了101366例个体病例，其中92860例患有食管炎，14201例患有狭窄。糜烂性食管炎的发生与骨关节炎（比值比 = 1.42，95%置信区间 = 1.36 - 1.48）、骨质疏松症（1.38，1.25 - 1.52）、背痛（1.49，1.42 - 1.56）、股骨骨折（1.46，0.92 - 2.32）、纤维织炎（1.57，1.41 - 1.75）、紧张性头痛（1.34，1.27 - 1.40）、强直性脊柱炎（1.33，1.24 - 1.42）、类风湿性关节炎（1.13，1.05 - 1.21）、干燥综合征（1.15，1.05 - 1.26）和系统性硬化症（6.16，4.65 - 8.14）相关。与NSAIDs相关的诊断对于食管炎和食管狭窄均为相似的危险因素。
NSAIDs治疗的多种疾病与食管糜烂或狭窄的风险显著增加相关；这两者的风险似乎相似。在一些合并病症中，潜在的疾病过程可能导致食管病变的发生。
