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为探讨非甾类抗炎药(NSAIDs)与严重的、急性非感染性肝损害间的关系,作者采用回顾性队列研究、交叉设计方法,收集了1982～1986年加拿大Saskatchewan健康数据库中228,392名成人645,456人年使用NSAIDe处方数量、种类和因新诊断急性肝损害住院的资料.结果,共34人因急性非感性性肝损害而入院治疗,其中16例近期正在使用NSAIDs,18例过去曾用过该类药物.近期用NSAIDs者急性肝损害的发病率为9/10万人年[95%可信区间(CI)6～15/10万人年],与近期未用NSAIDs者相比,用NSAIDs者发生急性肝损害的相对危险度(RR)为2.3(95%CI 1.1～4.9),超额危险度(AR)为5/10万人年、经按年龄,性别调整后,其相对危险度仍为1.7(95%CI0.8～3.7).但仅在排除了急性肝损害病例同时使用其它肝毒性药物后,NSAIDe与急性肝损害联系的强度才增加(RR=4.0,95%CI 0.9～19.0).接受1～9份处方药物治疗者发生急性肝损害的相对危险度相似,治疗时间长者危险度亦无增加.综上所述,作者认为使用进NSAIDs与严重的、急性非感染性肝损害有相关性,但其超额危险度较小.
To explore the relationship between non-steroidal anti-inflammatory drugs (NSAIDs) and severe acute noninfectious liver damage, the authors used a retrospective cohort study and a crossover design methodology to collect 228,392 adults from the Saskatchewan Health Database of Canada, 1982-1986 Of the 645,456 people who used NSAIDe for the number and type of hospitalizations and hospitalizations due to newly diagnosed acute liver injury, 34 were hospitalized for acute noninfarct hepatic impairment, 16 of whom were currently using NSAIDs and 18 of whom had previously used Among these drugs, the recent incidence of acute liver damage with NSAIDs is 9/10 million person years [95% confidence interval (CI) 6-15 / 10 million person years], compared with those who have not used NSAIDs recently The relative risk (RR) of acute liver injury among NSAIDs was 2.3 (95% CI 1.1 ~ 4.9) and the excess risk (AR) was 5/10 million person years. According to the age and sex, the relative risk (95% CI 0.8 ~ 3.7) .However, the correlation between NSAIDe and acute liver injury increased only when other hepatic toxicants were excluded from the study (RR = 4.0, 95% CI 0.9 ~ 19.0). The relative risk of acute liver injury among those who received 1 to 9 prescription drugs was similar, Treatment time nor increase the risk of the elderly. In summary, the authors believe that the use of NSAIDs and into a serious, acute liver injury caused by non-infectious correlated, but its small excess risk.