Shimada Tadahito, Yamagata Michiko, Hiraishi Hideyuki
Department of Gastroenterology, Dokkyo Medical University.
Nihon Rinsho. 2007 Oct;65(10):1824-9.
Helicobacter pylori (H. pylori) and non-steroidal anti-inflammatory drug (NSAID) are independent risk factors for peptic ulcers and ulcer complications and they have additive or synergistic effects. A meta-analysis showed that the OR for the incidence of peptic ulcer was 61.1 in patients infected with H. pylori and also taking NSAID when compared to patients uninfected with H. pylori and not taking NSAID. H. pylori eradication may prevent NSAID-induced ulcers in NSAID naive patients. In patients receiving long-term NSAID, proton pump inhibitor(PPI) is more effective in the prevention of ulcer recurrence and bleeding. However, H. pylori eradication should be considered in patients receiving long -term PPI maintenance treatment to prevent the development of corpus gastritis and gastric atrophy.
幽门螺杆菌(H. pylori)和非甾体抗炎药(NSAID)是消化性溃疡及其并发症的独立危险因素,二者具有相加或协同作用。一项荟萃分析表明,与未感染幽门螺杆菌且未服用非甾体抗炎药的患者相比,感染幽门螺杆菌且同时服用非甾体抗炎药的患者发生消化性溃疡的比值比(OR)为61.1。根除幽门螺杆菌可预防初治非甾体抗炎药患者发生非甾体抗炎药相关性溃疡。在长期服用非甾体抗炎药的患者中,质子泵抑制剂(PPI)预防溃疡复发和出血的效果更佳。然而,对于接受长期PPI维持治疗的患者,应考虑根除幽门螺杆菌以预防胃体胃炎和胃萎缩的发生。