Scheiman J M, Behler E M, Berardi R R, Elta G H
Department of Internal Medicine, University of Michigan, Ann Arbor.
Dig Dis Sci. 1989 Feb;34(2):229-32. doi: 10.1007/BF01536056.
The gastroduodenal mucosal damage caused by aspirin and nonsteroidal antiinflammatory drugs is a common clinical problem. We compared two medications designed to diminish mucosal damage: enteric-coated aspirin and salicylsalicylic acid (salsalate). Ten healthy volunteers were randomized to receive either 1.5 g salsalate twice a day or 650 mg enteric-coated aspirin four times a day for six days and were then crossed over to the other drug after a one-week medication-free period. Endoscopic inspection of gastroduodenal mucosa was performed at entry and again after six days of drug therapy for each medicine. Mean serum salicylate concentrations taken before the morning drug dose were 11.2 mg/dl for enteric-coated aspirin and 18.1 mg/dl for salsalate. Only one of 10 subjects receiving salsalate developed mild (grade 1) mucosal damage while six of 10 receiving enteric-coated aspirin developed moderate to severe damage (grade 2-3) (P = 0.01). Symptoms were mild in both groups. We conclude that salsalate causes less gastroduodenal mucosal damage than enteric-coated aspirin.
阿司匹林和非甾体类抗炎药所导致的胃十二指肠黏膜损伤是一个常见的临床问题。我们比较了两种旨在减轻黏膜损伤的药物：肠溶阿司匹林和水杨酸水杨酸酯（双水杨酸酯）。10名健康志愿者被随机分为两组，一组每天服用两次1.5克双水杨酸酯，另一组每天服用四次650毫克肠溶阿司匹林，为期六天，然后在停药一周后交叉服用另一种药物。在开始用药时以及每种药物治疗六天后，对胃十二指肠黏膜进行内镜检查。早晨服药前测得的平均血清水杨酸浓度，肠溶阿司匹林组为11.2毫克/分升，双水杨酸酯组为18.1毫克/分升。接受双水杨酸酯治疗的10名受试者中只有1人出现轻度（1级）黏膜损伤，而接受肠溶阿司匹林治疗的10名受试者中有6人出现中度至重度损伤（2 - 3级）（P = 0.01）。两组的症状均较轻微。我们得出结论，双水杨酸酯比肠溶阿司匹林引起的胃十二指肠黏膜损伤更少。
