Intestinal permeability and inflammation in patients on NSAIDs
Intestinal permeability and inflammation in patients on NSAIDs
复制标题
DOI：
10.1136/gut.43.4.506
复制
发表时间：
1998-10-01
期刊：
影响因子：
24.5
通讯作者：
Bjarnason, I
中科院分区：
文献类型：
--
作者：
Sigthorsson, G;Tibble, J;Bjarnason, I
背景：非甾体抗炎药（NSAIDs）增加小肠通透性并引起炎症的频率尚不确定。目的：观察大量长期服用非甾体抗炎药患者的小肠通透性和炎症情况。方法：68例接受6种不同非甾体抗炎药治疗超过6个月的患者在3种不同的试验剂量渗透压（等渗透压、低渗透压和高渗透压）下进行了联合吸收-渗透性试验，286例接受12种不同非甾体抗炎药治疗的患者进行了铟-ll白细胞粪便排泄研究，以评估肠道炎症的患病率和严重程度。结果：等渗试验和高渗试验显示3-0-甲基- d -葡萄糖、d -木糖和l-鼠李糖吸收不良，低渗试验和高渗试验的肠通透性变化明显比等渗试验更明显、更频繁。序贯研究显示，13名患者中分别有4名和9名在接受NSAIDs治疗3个月和6个月后出现炎症。286例服用各种非甾体抗炎药的患者中，除了服用阿司匹林和纳布美酮的患者没有肠道炎症的证据外，肠道炎症的患病率（54-72%）和严重程度没有显著差异（p < 0.01）。炎症变化与年龄、性别、非甾体抗炎药剂量、病程长短或摄入非甾体抗炎药没有显著相关性。结论-肠通透性试验剂量组成是评估非甾体抗炎药对肠道完整性影响的重要因素。所有传统的非甾体抗炎药都与小肠炎症有同样的关系，除了阿司匹林和纳布美酮似乎对小肠没有影响。
Background-The frequency with which non-steroidal anti-inflammatory drugs (NSAIDs) increase small intestinal permeability and cause inflammation is uncertain.Aims-To examine small intestinal permeability and inflammation in a large number of patients on long term NSAIDs.Methods-Sixty eight patients receiving six different NSAIDs for over six months underwent combined absorption-permeability tests at three different test dose osmolarities (iso-, hypo-, and hyperosmolar), Two hundred and eighty six patients on 12 different NSAIDs underwent indium-lll white cell faecal excretion studies to assess the prevalence and severity of intestinal inflammation.Results-The iso- and hyperosmolar test-a showed significant malabsorption of 3-0-methyl-D-glucose, D-xylose, and L-rhamnose, Intestinal permeability changes were significantly more pronounced and frequent with the hypo- and hyperosmolar as opposed to the isoosmolar test. Sequential studies showed that four and nine patients (of 13) developed inflammation after three and six months treatment with NSAIDs, respectively. There was no significant difference (p>0.1) in the prevalence (54-72%) or severity of intestinal inflammation in the 286 patients taking the various NSAIDs apart from those on aspirin and nabumetone, these having no evidence of intestinal inflammation. There was no significant correlation between the inflammatory changes and age, sex, dose of NSAID, length of disease,or NSAID ingestion.Conclusions-Intestinal permeability test dose composition is an important factor when assessing the effects of NSAIDs on intestinal integrity. All the conventional NSAIDs studied were equally associated with small intestinal inflammation apart from aspirin and nabumetone which seem to spare the small bowel.