胃肠道穿孔：与皮质类固醇使用及慢性阻塞性肺疾病的关系——病例报告
Gastrointestinal perforation: relation to corticosteroid use and COPD - a case report.
作者信息
Nguyen Michael H K, Isaac Krista M, Dougherty Rebecca
机构信息
Department of Internal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA;
Department of Internal Medicine, Lankenau Medical Center, Philadelphia, PA, USA.
出版信息
J Community Hosp Intern Med Perspect. 2016 Sep 7;6(4):32129. doi: 10.3402/jchimp.v6.32129. eCollection 2016.
Gastrointestinal perforations are a complication of 2-10% of duodenal ulcers. There are a variety of etiologies associated with duodenal ulcer formation and its complications. Corticosteroid use is associated with an increased risk of duodenal ulcer perforation, with the first documented case in 1950. Other important medications associated with perforation include NSAIDS and opioids. Beyond medication, one of the most common disease processes, chronic obstructive pulmonary disease (COPD), has been found to be associated with peptic ulcer disease. Up to 30% of COPD patients have been found to have peptic ulcers, and COPD frequency in peptic ulcer disease is 2-3 times the general population. We herein present a case of an acute duodenal ulcer perforation in a patient receiving corticosteroid treatment for an acute COPD exacerbation.
胃肠道穿孔是十二指肠溃疡2%-10%的并发症。十二指肠溃疡形成及其并发症有多种病因。使用皮质类固醇会增加十二指肠溃疡穿孔的风险，1950年有首例记录病例。与穿孔相关的其他重要药物包括非甾体抗炎药和阿片类药物。除药物外，最常见的疾病之一慢性阻塞性肺疾病（COPD）已被发现与消化性溃疡病有关。高达30%的COPD患者被发现患有消化性溃疡，消化性溃疡病中COPD的发病率是普通人群的2至3倍。我们在此报告一例因急性COPD加重而接受皮质类固醇治疗的患者发生急性十二指肠溃疡穿孔的病例。
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