Zwolińska-Wcisło Małgorzata, Ptak-Belowska Agata, Targosz Aneta, Urbańczyk Katarzyna, Rozpondek Piotr, Galicka-Latała Danuta, Mach Tomasz
Klinika Gastroenterologii i Hepatologii, Collegium Medicum, Uniwersytet Jagielloński w Krakowie.
Przegl Lek. 2009;66(9):503-7.
Non specific inflammations of the intestine are the group of chronic disorders, such as ulcerative colitis and Crohn's disease and with episodic aggravation of inflammatory lesions, called active phase and non-active phase, called remission. Non-steroid antiinflammatory drugs (NSAIDS) are one of the most frequently used medications in the World. NSAIDS therapy in ulcerative colitis patients is a very important clinical problem, because of frequent extraintestinal symptoms, such as arthritis, which make patients to take these drugs. But the mechanisms of the NSAIDS influence on the course of inflammatory diseases of inferior part of gastrointestinal tract is still not known. Our results of clinical studies indicated the influence of nonselective and selective COX2 inhibitors on ulcerative colitis activity. However clinical aggravation was detected in 8% of patients treated with conventional NSAIDS and in one person administered selective COX2 inhibitor. Administration of the conventional NSAIDS as well as coxibs, significantly influenced severity of diarrhea. Moreover conventional COX inhibitors increased severity of colon bleeding and endoscopic colon inflammatory lesions in comparison to ulcerative colitis patients, as well not administered NSAIDS as given coxibs. Total patients evaluation involving the intensity of clinical symptoms did not reveal significant differences between examined groups. The above results showed, that the balance between risk and advantages resulting from administration of NSAIDS both, non-selective and selective COX is to be accepted in ulcerative colitis patients in non-active phase.
肠道非特异性炎症是一组慢性疾病，如溃疡性结肠炎和克罗恩病，炎症病变有发作性加重，分为活动期和缓解期（非活动期）。非甾体抗炎药（NSAIDS）是世界上最常用的药物之一。在溃疡性结肠炎患者中使用NSAIDS治疗是一个非常重要的临床问题，因为患者常有肠道外症状，如关节炎，这使得患者会服用这些药物。但NSAIDS对胃肠道下部炎症性疾病病程的影响机制仍不清楚。我们的临床研究结果表明非选择性和选择性COX2抑制剂对溃疡性结肠炎活动有影响。然而，在接受传统NSAIDS治疗的患者中有8%出现临床病情加重，在使用选择性COX2抑制剂的1名患者中也出现了病情加重。使用传统NSAIDS以及昔布类药物均显著影响腹泻的严重程度。此外，与溃疡性结肠炎患者相比，无论是未使用NSAIDS还是使用昔布类药物，传统COX抑制剂都会增加结肠出血的严重程度和内镜下结肠炎症病变。涉及临床症状强度的总体患者评估未显示各检查组之间存在显著差异。上述结果表明，在非活动期溃疡性结肠炎患者中，使用非选择性和选择性COX的NSAIDS所带来的风险和益处之间的平衡是可以接受的。
