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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Nonsteroidal anti-inflammatory drug use, chronic liver disease, and hepatocellular carcinoma: The egg of columbus or another illusion?
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Nonsteroidal anti-inflammatory drug use, chronic liver disease, and hepatocellular carcinoma: The egg of columbus or another illusion?

机译：非甾体抗炎药的使用，慢性肝病和肝细胞癌：哥伦布卵还是其他幻觉？

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Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to reduce chronic inflammation and risk of many cancers, but their effect on risk of hepatocellular carcinoma (HCC) and death due to chronic liver disease (CLD) has not been investigated. Methods: We analyzed prospective data on 300 504 men and women aged 50 to 71 years in the National Institutes of Health-AARP Diet and Health Study cohort and linked self-reported aspirin and non-aspirin NSAID use with registry confirmed diagnoses of HCC and death due to CLD. We calculated hazard rate ratios (RRs) and their two-sided 95% confidence intervals (CIs) using Cox proportional hazard regression models with adjustment for age, sex, race/ethnicity, cigarette smoking, alcohol consumption, diabetes, and body mass index. All tests of statistical significance were two-sided. Results: Aspirin users had statistically significant reduced risks of incidence of HCC (RR 5 0.59; 95% CI 5 0.45 to 0.77) and mortality due to CLD (RR 5 0.55; 95% CI 5 0.45 to 0.67) compared to those who did not use aspirin. In contrast, users of non-aspirin NSAIDs had a reduced risk of mortality due to CLD (RR 5 0.74; 95% CI 5 0.61 to 0.90) but did not have lower risk of incidence of HCC (RR 5 1.08; 95% CI 5 0.84 to 1.39) compared to those who did not use non-aspirin NSAIDs. The risk estimates did not vary in statistical significance by frequency (monthly, weekly, daily) of aspirin use, but the reduced risk of mortality due to CLD was statistically significant only among monthly users of non-aspirin NSAIDs compared to nonusers. Conclusions: Aspirin use was associated with reduced risk of developing HCC and of death due to CLD whereas nonaspirin NSAID use was only associated with reduced risk of death due to CLD.
机译：背景：非甾体类抗炎药（NSAIDs）已被证明可以减少慢性炎症和许多癌症的风险，但是尚未研究其对肝细胞癌（HCC）风险和慢性肝病（CLD）致死的影响。方法：我们分析了美国国立卫生研究院-AARP饮食与健康研究队列中300 504名年龄在50至71岁之间的男性和女性的前瞻性数据，并将自我报告的阿司匹林和非阿司匹林NSAID的使用与经登记的确诊为HCC和死亡的诊断相关联由于CLD。我们使用Cox比例风险回归模型对年龄，性别，种族/民族，吸烟，饮酒，饮酒，糖尿病和体重指数进行了调整，从而计算了危险率比（RRs）及其两侧的95％置信区间（CIs）。所有统计显着性检验均为双面检验。结果：与未服用阿司匹林的人相比，阿司匹林使用者的肝癌发生风险（RR 5 0.59; 95％CI 5 0.45至0.77）和因CLD致死的风险（RR 5 0.55; 95％CI 5 0.45至0.67）显着降低使用阿司匹林。相比之下，非阿司匹林非甾体抗炎药的使用者因CLD导致的死亡风险降低（RR 5 0.74; 95％CI 5 0.61至0.90），但没有降低的HCC发生风险（RR 5 1.08; 95％CI 5与未使用非阿司匹林NSAID的患者相比，则为0.84至1.39）。根据使用阿司匹林的频率（每月，每周，每天），风险估计的统计显着性没有变化，但是与非使用者相比，仅在每月非阿司匹林NSAID使用者中，CLD导致的死亡风险降低具有统计学意义。结论：阿司匹林的使用与减少因CLD导致的HCC发生和死亡的风险有关，而非阿司匹林NSAID的使用仅与减少由CLD导致的死亡风险有关。

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