Bogas Mónica, Afonso Maria do Carmo, Araújo Domingos
Serviço de Reumatologia, Centro Hospitalar do Alto Minho, Ponte de Lima.
Acta Reumatol Port. 2006 Jul-Sep;31(3):227-35.
In addition to adverse effects on gastroduodenal mucosa, it is recognized that non-steroidal antiinflammatory drugs (NSAIDs) can also induce toxicity to the lower intestinal tract. The diagnostic tools available and the lack of information about its pathogenesis and clinical importance are still limitations for its diagnosis. For their anti-inflammatory and analgesic effects, NSAIDs are largely used to treat musculoskeletal disorders. Increased intestinal permeability and inflammation are the main pathogenic steps in the development of NSAIDs enteropathy which may result in bleeding and protein loss. Selective COX-2 inhibitors, although seem safer, may also induce intestinal lesions. In this article, about NSAIDs damage to the lower intestine, we review aspects about its prevalence, pathogenesis, lesions, clinical spectrum and practical clues to diagnosis and treatment.
除了对胃十二指肠黏膜有不良影响外，人们还认识到非甾体抗炎药（NSAIDs）也会对下肠道产生毒性。现有的诊断工具以及关于其发病机制和临床重要性的信息不足，仍然是其诊断的局限性。由于其抗炎和镇痛作用，NSAIDs被广泛用于治疗肌肉骨骼疾病。肠道通透性增加和炎症是NSAIDs肠病发展的主要致病步骤，这可能导致出血和蛋白质流失。选择性COX-2抑制剂虽然似乎更安全，但也可能诱发肠道病变。在本文中，我们回顾了NSAIDs对下肠道损伤的患病率、发病机制、病变、临床谱以及诊断和治疗的实用线索等方面。
