Lee Jun Haeng, Lee Yong Chan, Jeon Seong Woo, Kim Jeong Wook, Lee Sang Woo
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2009 Nov;54(5):309-17. doi: 10.4166/kjg.2009.54.5.309.
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.
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。