Iguchi Munetaka, Kakimoto Kazuki, Kuramoto Takanori, Nakazawa Kei, Kubota Minori, Hirata Yuki, Fujiwara Kaori, Harada Satoshi, Sakanaka Taisuke, Ota Kazuhiro, Edogawa Shoko, Kojima Yuichi, Nouda Sadaharu, Okada Toshihiko, Kawakami Ken, Takeuchi Toshihisa, Inoue Takuya, Higuchi Kazuhide
Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan.
J Clin Biochem Nutr. 2018 Mar;62(2):174-178. doi: 10.3164/jcbn.17-46. Epub 2018 Jan 11.
Low-dose aspirin, which is widely used to reduce the risk of cardio- and cerebrovascular thrombosis, often induces gastroenteropathy by increasing the permeability of the mucosa. However, therapeutic strategies for patients with low-dose aspirin-induced small intestinal injury have not been determined. We evaluated the preventative effect of egualen sodium hydrate, a gastro-protective agent that suppresses indomethacin-induced small-intestinal damage in rats, against small-intestinal mucosal damage induced by low-dose aspirin in healthy adult male volunteers. Participants were randomly allocated to receive aspirin 100 mg/kg daily (control group, = 10) or aspirin 100 mg/kg plus egualen sodium 30 mg daily (egualen sodium group, = 10). Small intestinal mucosal injury was evaluated by capsule endoscopy two weeks after initiation of drug administration. Fecal analyses (occult blood test, immunochemical test, transferrin measurement and calprotectin measurement) were carried out before and after treatment. Egualen sodium significantly suppressed the total number of small intestinal injuries detected by capsule endoscopy and the positive ratio for the fecal occult blood test. Daily use of 30 mg of egualen sodium showed a preventative effect on low-dose aspirin-induced small intestinal injury. Since acid suppression therapy was reported to exacerbate NSAIDs-induced enteropathy via dysbiosis, egualen sodium may be useful for patients treated with low-dose aspirin.
低剂量阿司匹林被广泛用于降低心脑血管血栓形成的风险，但它常常通过增加黏膜通透性而诱发胃肠病。然而，针对低剂量阿司匹林所致小肠损伤患者的治疗策略尚未确定。我们评估了水化依卡倍特钠（一种可抑制吲哚美辛诱导的大鼠小肠损伤的胃保护剂）对健康成年男性志愿者低剂量阿司匹林所致小肠黏膜损伤的预防作用。参与者被随机分配，分别每日接受100 mg/kg阿司匹林（对照组，n = 10）或100 mg/kg阿司匹林加30 mg水化依卡倍特钠（水化依卡倍特钠组，n = 10）。给药两周后通过胶囊内镜评估小肠黏膜损伤情况。治疗前后进行粪便分析（潜血试验、免疫化学试验、转铁蛋白测定和钙卫蛋白测定）。水化依卡倍特钠显著抑制了通过胶囊内镜检测到的小肠损伤总数以及粪便潜血试验的阳性率。每日使用30 mg水化依卡倍特钠对低剂量阿司匹林所致小肠损伤具有预防作用。由于据报道抑酸治疗会通过生态失调加重非甾体抗炎药所致的肠病，因此水化依卡倍特钠可能对接受低剂量阿司匹林治疗的患者有用。
