Angi Andrea, Lakatos László
Csolnoky Ferenc Megyei Kórház, Belgyógyászati Centrum, Veszprém.
Orv Hetil. 2009 Jan 4;150(1):27-34. doi: 10.1556/OH.2009.28508.
Non-steroidal antiinflammatory drugs (NSAID) are among the most commonly used drugs worldwide. Together with the beneficial effects, several adverse effects have become evident in the past decades. NSAIDs may damage any part of the gastrointestinal (GI) tract. The adverse effect in the lower GI tract was thought to be less important, but more and more data confirm that NSAIDs can cause equally severe lesions in the lower GI tract as well, only the diagnostic procedures are limited. NSAIDs may damage the intact mucosa, and they also may cause flare-up of a preexisting disease. Adverse events in the lower GI tract are caused mainly by the dual (COX-1 and COX-2) inhibitors. Besides the inhibiting of the cyclooxygenase enzymes, an important step is the local effect of the drug that initiates the chain reaction with the damage of the epithelial cells (increase of mucosal permeability, influx of luminal factors, produce of inflammatory mediators etc.). The spectrum of adverse effects of NSAIDs on the lower GI are reviewed according to the latest literature and the available prevention and therapeutic strategies.
非甾体抗炎药（NSAID）是全球最常用的药物之一。在过去几十年中，除了有益作用外，几种不良反应也已显现。NSAIDs可能会损害胃肠道（GI）的任何部位。人们曾认为下消化道的不良反应不太重要，但越来越多的数据证实，NSAIDs在下消化道也可导致同样严重的病变，只是诊断方法有限。NSAIDs可能会损害完整的黏膜，还可能导致原有疾病的发作。下消化道的不良事件主要由双重（COX-1和COX-2）抑制剂引起。除了抑制环氧化酶外，药物的局部作用引发与上皮细胞损伤相关的连锁反应（黏膜通透性增加、腔内因子流入、炎症介质产生等）也是一个重要步骤。根据最新文献以及现有的预防和治疗策略，对NSAIDs在下消化道的不良反应谱进行综述。
