非甾体抗炎药对肠黏膜通透性的影响及替普瑞酮的保护作用  

Effects of non-steroidal anti-inflammatory drugs on intestinal permeability and the protective effect of teprenone

作　　者：高二鹏 汪国生[1] 刘晓昌[2] 梅俏[2] 许建明[2] 

机构地区：[1]安徽医科大学附属省立医院风湿免疫科,合肥230001 [2]安徽医科大学第一附属医院消化内科,合肥230022

出　　处：《安徽医科大学学报》2014年第12期1747-1750,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省高校自然科学重点项目(编号:KJ2010A188)

摘　　要：目的探讨非甾体抗炎药(NSAIDs)对类风湿关节炎(RA)及骨关节炎(OA)患者小肠通透性的影响及替普瑞酮对NSAIDs所致小肠损伤的防治作用。方法收集服用NSAIDs的RA患者30例、OA患者16例,其他结缔组织病患者5例,健康对照者10例。高效液相色谱法测定尿液中乳果糖和甘露醇(L/M)排泄率比值,比较未使用NSAIDs,使用NSAIDs后,及加用替普瑞酮后,L/M排泄率比值。结果 1使用NSAIDs的17例患者L/M排泄率比值较10例健康对照者升高,但差异无统计学意义;使用NSAIDs的34例患者L/M排泄率比值较未使用NSAIDs患者显著升高(P<0.01);10例使用替普瑞酮的患者L/M排泄率比值较单纯使用NSAIDs患者显著降低(P<0.01);2服用不同NSAIDs患者L/M排泄率比值排序为奥沙普嗪<双氯芬酸<氯诺昔康,但3组间差异无统计学意义;3 RA患者L/M排泄率比值显著高于OA患者和健康对照者,差异有统计学意义(P<0.05)。结论 NSAIDs增加OA患者小肠黏膜通透性;NSAIDs对小肠黏膜通透性改变与COX-2选择性无关;RA患者肠黏膜通透性显著增加;替普瑞酮能保护NSAIDs引起的肠黏膜通透性改变。Objective To investigate the effect of non-steroidal anti-inflammatory drugs （NSAIDs） on intestinal permeability and the protection of teprenone in patients with rheumatoid arthritis （RA） and osteoarthritis （OA）.Methods Thirty patients with RA,16 patients with OA,5 patients with other rheumatic diseases and 10 healthy controls were enrolled in the study.High performance liquid chromatography was used to determine urine lactulose and mannitol （L/M） excretion ratio.L/M excretion ratio was compared before and after NSAIDs use and combination of NSAIDs and teprenone.Results ① Compared with healthy controls,L/M excretion ratio increased in 17 patients without NSIADs,but the difference was not statistically significant.L/M excretion ratio in 34 patients with NSAIDs was significantly higher than that in patients without NSAIDs （P ＜ 0.01） ; L/M excretion ratio in patients with combination of NSAIDs and teprenone was significantly lower than that in patients wtih NSAIDs （P ＜ 0.01） ;② L/M excretion ratio in patients with different NSAIDs therapy was oxaprozin ＜ diclofenac ＜ lornoxicam,but the differences were not statistically significant; ③ The L/M ratio in patients with RA was significantly higher than that in patients with OA and healthy controls （P ＜ 0.05）.Conclusion NSAIDs increase the permeability of the intestinal mucosa in patients with arthritis.The change of intestinal mucosal permeability is unrelated to COX-2 selection.Intestinal permeability in patients with rheumatoid arthritis increases significantly.Teprenone can protect intestinal permeability against NSAIDs.

关 键 词：非甾体抗炎药 小肠通透性 替普瑞酮 

分 类 号：R979.9[医药卫生—药品] R574.4[医药卫生—药学]