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阿司匹林及非甾体抗炎药所致消化性溃疡的诊断与治疗

[Diagnosis and treatment of aspirin--and NSAID-induced peptic ulcers].

作者信息

Satoh Kiichi, Tanabe Hiroki, Ichiishi Eiichiro, Ando Katsuyoshi

出版信息

Nihon Rinsho. 2015 Jul;73(7):1110-5.

Abstract

A Japanese case-control study showed the odds ratio of upper gastrointestinal bleeding was 5.5 for aspirin and 6.1 for other NSAIDs. A Japanese cohort study showed that peptic ulcers were found in 6.5% of 1,454 patients receiving low-dose aspirin (LDA). Some endoscopic studies reported that NSAID users often had antral, multiple, and irregular ulcers, irrespective of Helicobacter pylori status. Proton-pump inhibitor (PPI) and misoprostol should be used for therapy for NSAID-ulcers. Maintenance therapy with PPI should be given for prevention of relapse of ulcers of NSAIDs and LDA users. PPI and histamine 2-recetor antagonist were effective for prevention of upper GI mucosal injury in patients receiving LDA.

摘要

一项日本的病例对照研究表明,阿司匹林导致上消化道出血的比值比为5.5,其他非甾体抗炎药为6.1。一项日本队列研究显示,在1454名接受低剂量阿司匹林(LDA)治疗的患者中,6.5%发现有消化性溃疡。一些内镜研究报告称,非甾体抗炎药使用者常出现胃窦部、多发且不规则的溃疡,与幽门螺杆菌感染状况无关。质子泵抑制剂(PPI)和米索前列醇应用于治疗非甾体抗炎药相关性溃疡。应给予PPI维持治疗以预防非甾体抗炎药和LDA使用者溃疡复发。PPI和组胺2受体拮抗剂对预防接受LDA治疗患者的上消化道黏膜损伤有效。

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