非甾体抗炎药引发小肠不良反应因素分析及处理

Analysis and treatment of small intestinal adverse reactions induced by NSAIDs

目的探究非甾体抗炎药在应用过程中引起患者小肠不良反应的危险因素，为临床药物的合理使用提供参考。方法通过调查问卷的方式对2014年6月至2016年6月在本院及附属医院就诊的843例0．5～1．0年内规律使用非甾体抗炎药的患者进行调查。问卷内容主要包括年龄、性别、既往病史、同期合并用药、吸烟、饮酒、饮食习惯、生活习惯等。对数据统计后，按照有无发生小肠不良反应分为2组，并使用单因素分析和多因素Logistic回归分析方法，确定引发小肠不良反应的危险因素。结果通过对调查问卷的筛查排除后，排除49例，纳人研究794例，其中392例出现小肠不良反应，402例未出现小肠不良反应。年龄、性别、不良生活习惯、不良饮食习惯、上消化道疾病病史、风湿疾病病史、未使用抗凝药为NSAIDs引发小肠不良反应的危险因素，同时也为NSAIDs引发小肠不良反应的独立危险因素。结论应用NSAIDs6个月以上者，小肠炎症反应是其常见的小肠不良反应；且在用药时应关注年龄、性别、病史、用药史等引起小肠不良反应的危险因素。同时，在规避危险因素后，应采取具体措施防治不良反应。

Objective To explore the risk factors of small intestinal adverse reactions caused by NSAIDs and to provide some references for the rational use of clinical drugs. Methods 843 patients regularly using NSAIDs for 0.5-1.0 years from our hospital from June, 2014 to June, 2016 were investigated by questionnaire. The questionnaire included age, gender, past medical history, concurrent medication, smoking, drinking, eating habits, lifestyle, and so on. After statistical analysis, according to the occurrence of small intestinal adverse reactions they were divided into 2 groups. Single factor analysis and multivariate Logistic regression analysis were used to determine the risk factors of small intestinal adverse reactions. Result After the screening of the questionnaire, 49 cases were excluded and 794, 392 with intestinal adverse reactions and 402 without, included. Age, gender, bad life habits, bad eating habits, history of digestive tract diseases, rheumatic disease, and not using anticoagulants were risk factors and independent risk factors of small intestine adverse reactions caused by NSAIDs. Conclusion The application of NSAIDs over 6 months commonly causes intestinal inflammation. The risk factors, such as age, gender, disease history, and medication history, should be paid attention to during medication. At the same time, concrete measures should be taken to control the adverse reactions.