Prichard P J, Hawkey C J
Department of Medicine, Flinders Medical Centre, Adelaide, Australia.
Dig Dis. 1989;7(1):28-38. doi: 10.1159/000171204.
Aspirin almost invariably causes acute mucosal injury to the stomach or duodenum as evidenced by erosions seen endoscopically, extensive surface cell disruption on histology, reduced mucosal potential difference and increased gastric bleeding. This injury is usually minor and transient, and not associated with symptoms. However, in the elderly recent aspirin intake may be associated with bleeding peptic ulcer, and along with other NSAIDs, may be causal in a third of cases. Regular chronic aspirin intake may also be associated with gastric ulceration. Such ulceration, however, although seemingly capable of healing despite continued aspirin or other NSAID use, may take longer to do so. Although aspirin and other NSAIDs have a strong connection with gastroduodenal problems the risk in an individual needs to be balanced by the likelihood of such events. Given their widespread use, the serious side effects of these drugs occur in only a small proportion of users. This, however, does not mitigate against careful prescription.
阿司匹林几乎总会导致胃或十二指肠的急性黏膜损伤，内镜检查可见糜烂、组织学上广泛的表面细胞破坏、黏膜电位差降低以及胃出血增加，均证实了这一点。这种损伤通常轻微且短暂，与症状无关。然而，在老年人中，近期服用阿司匹林可能与消化性溃疡出血有关，并且与其他非甾体抗炎药一起，可能是三分之一病例的病因。长期规律服用阿司匹林也可能与胃溃疡有关。然而，这种溃疡虽然在持续使用阿司匹林或其他非甾体抗炎药的情况下似乎能够愈合，但可能需要更长时间。尽管阿司匹林和其他非甾体抗炎药与胃十二指肠问题有密切联系，但个体的风险需要与此类事件的可能性相权衡。鉴于它们的广泛使用，这些药物的严重副作用仅发生在一小部分使用者中。然而，这并不妨碍谨慎处方。
