NONSTEROIDAL ANTIINFLAMMATORY DRUG-USE AND INCREASED RISK FOR PEPTIC-ULCER DISEASE IN ELDERLY PERSONS
NONSTEROIDAL ANTIINFLAMMATORY DRUG-USE AND INCREASED RISK FOR PEPTIC-ULCER DISEASE IN ELDERLY PERSONS
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DOI：
10.7326/0003-4819-114-4-257
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发表时间：
1991-02-15
影响因子：
39.2
通讯作者：
RAY, WA
中科院分区：
文献类型：
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作者：
GRIFFIN, MR;PIPER, JM;RAY, WA
目的：评价与使用非阿司匹林非甾体类抗炎药相关的消化性溃疡疾病的相对危险性。设计：巢式病例对照研究。背景：田纳西州医疗补助计划。参与者：65岁及以上的医疗补助计划参保者被纳入研究。从1984年到1986年，1415例患者曾因确认的消化性溃疡疾病住院治疗。7063名对照者代表了其他医疗补助计划参保者的分层随机样本。测量结果和主要结果：与未使用非阿司匹林非甾体类抗炎药的患者相比，目前使用非阿司匹林非甾体类抗炎药的患者发生消化性溃疡疾病的估计相对风险为4.1 （95% CI, 3.5 - 4.7）。对于目前的使用者，风险随着剂量的增加而增加，从最低剂量类别的相对风险为2.8 （CI， 1.8至4.3）到最高剂量类别的相对风险为8.0 （CI， 4.4至14.8）。风险在使用的第一个月最大（相对风险，7.2；CI， 4.9至10.5）。如果这种关联是完全因果的，研究样本中29%的消化性溃疡是由使用这些药物引起的，并且与使用这些药物相关的额外风险是每1000人-年接触的17.4例溃疡住院。结论：这些数据支持其他研究结果，表明严重溃疡疾病的临床显著风险与非阿司匹林非甾体抗炎药的使用相关。数据显示，这种风险随着剂量和使用时间的增加而增加，使用这些药物可能是老年人中很大一部分消化性溃疡疾病的原因。
Objective: To evaluate the relative risk for peptic ulcer disease that is associated with the use of nonaspirin nonsteroidal anti-inflammatory drugs.Design: Nested case-control study.Setting: Tennessee Medicaid program.Participants: Medicaid enrollees 65 years of age or older were included in the study. The 1415 case patients had been hospitalized for confirmed peptic ulcer disease at some point from 1984 through 1986. The 7063 control persons represented a stratified random sample of other Medicaid enrollees.Measurements and Main Results: The estimated relative risk for the development of peptic ulcer disease among current users of nonaspirin nonsteroidal anti-inflammatory drugs, compared with that among nonusers, was 4.1 (95% CI, 3.5 to 4.7). For current users, the risk increased with increasing dose, from a relative risk of 2.8 (CI, 1.8 to 4.3) for the lowest to a relative risk of 8.0 (CI, 4.4 to 14.8) for the highest dose category. The risk was greatest in the first month of use (relative risk, 7.2; CI, 4.9 to 10.5). If the association is fully causal, 29% of peptic ulcers in the study sample resulted from the use of these drugs, and the excess risk associated with such use was 17.4 hospitalizations for ulcer disease per 1000 person-years of exposure.Conclusions: These data support other findings indicating that a clinically significant risk for serious ulcer disease is associated with the use of nonaspirin nonsteroidal anti-inflammatory drugs. The data show that this risk increases with dose and recency of use and that use of these drugs may be responsible for a large proportion of peptic ulcer disease among elderly persons.