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[非甾体抗炎药相关性消化性溃疡防治指南]

[Guidelines of prevention and treatment for NSAID-related peptic ulcers].

作者信息

Lee Jun Haeng, Lee Yong Chan, Jeon Seong Woo, Kim Jeong Wook, Lee Sang Woo

机构信息

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Korean J Gastroenterol. 2009 Nov;54(5):309-17. doi: 10.4166/kjg.2009.54.5.309.

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications in Korea. Gastrointestinal toxicity, including peptic ulcer, is a common adverse effect of NSAIDs. Risk factors for NSAID-related peptic ulcer include a previous history of peptic ulcer, advanced age, high dose, concomitant use of corticosteroids, anticoagulants, other NSAIDs including low-dose aspirin. Preventive measure(s), such as COX-2 inhibitor, proton pump inhibitor or misoprostrol, should be done for patients requiring NSAID therapy who have high-risk factor(s) for peptic ulcer. Low dose aspirin also increases the risk of peptic ulcer, so preventive measure(s) should be done for high-risk patients. The eradication of Helicobacter pylori is recommended for high-risk NSAID-users. Treatment strategies for peptic ulcers in NSAID users are mostly the same for peptic ulcers in NSAID non-users.

摘要

非甾体抗炎药(NSAIDs)是韩国最常用的药物之一。包括消化性溃疡在内的胃肠道毒性是NSAIDs常见的不良反应。NSAID相关消化性溃疡的危险因素包括消化性溃疡病史、高龄、高剂量、同时使用皮质类固醇、抗凝剂、其他NSAIDs(包括低剂量阿司匹林)。对于需要NSAID治疗且有消化性溃疡高危因素的患者,应采取预防措施,如使用COX-2抑制剂、质子泵抑制剂或米索前列醇。低剂量阿司匹林也会增加消化性溃疡的风险,因此高危患者也应采取预防措施。建议对NSAID高危使用者根除幽门螺杆菌。NSAID使用者消化性溃疡的治疗策略与非NSAID使用者消化性溃疡的治疗策略基本相同。

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