Scheiman James M
Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
J Clin Gastroenterol. 2016 Jan;50(1):5-10. doi: 10.1097/MCG.0000000000000432.
Gastroenterologists care for users of nonsteroidal anti-inflammatory drugs (NSAIDs) when the vast population exposed to the medication class experiences a relatively uncommon serious gastrointestinal (GI) side effect. As serious adverse cardiovascular (CV) effects of these drugs have also been recognized, there remains continued confusion about the best treatment for patients who benefit from NSAID therapy and are at risk for GI and CV adverse events. Recognition of those patients at risk and strategies to reduce the adverse side effects of NSAIDs continues to provide an opportunity to improve patient outcomes. This review discusses the injury induced by these agents throughout the GI tract as well as strategies to prevent acute injury and reduce the development of serious adverse events. NSAID medication selection as well as GI cotherapy should balance individual patients' GI and CV risks.
当大量使用非甾体抗炎药（NSAIDs）的人群出现相对罕见的严重胃肠道（GI）副作用时，胃肠病学家会对这些患者进行治疗。由于这些药物的严重心血管（CV）不良影响也已得到认识，对于那些从NSAID治疗中获益且有发生GI和CV不良事件风险的患者，最佳治疗方案仍存在持续的困惑。识别这些有风险的患者以及减少NSAIDs不良反应的策略，仍然为改善患者预后提供了机会。本综述讨论了这些药物在整个胃肠道引起的损伤，以及预防急性损伤和减少严重不良事件发生的策略。NSAID药物的选择以及胃肠道联合治疗应平衡个体患者的GI和CV风险。
