Joo Moon Kyung
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2020 Nov 25;76(5):227-231. doi: 10.4166/kjg.2020.141.
Non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin are the most frequently prescribed drugs worldwide, and their long-term use often leads to peptic ulcers (PUs) along with serious complications, such as bleeding and perforation. () infection is a significant risk factor for developing NSAID-related PU and ulcer bleeding during long-term aspirin use. In a revised version of the Clinical Guidelines for Drug-induced Peptic Ulcer, two statements regarding eradication are recommended. 1) Patients scheduled for long-term NSAID therapy should be tested and treated for infection to prevent PU and its complications. 2) Patients with a history of PU receiving long-term low-dose aspirin (LDA) therapy should undergo treatment for infection to prevent PU and its complications. On the other hand, unlike NSAID-naïve patients, the preventive effects of eradication in chronic NSAID users are unclear. In addition, anti-ulcer drugs, such as proton pump inhibitors, may be necessary for maintenance therapy after eradication in a subset of long-term LDA users, particularly if the patients are taking concomitant antiplatelet agents or anticoagulants.
非甾体抗炎药（NSAIDs）和阿司匹林是全球处方量最高的药物，长期使用这些药物往往会导致消化性溃疡（PUs）以及严重并发症，如出血和穿孔。（）感染是长期使用阿司匹林期间发生NSAID相关PU和溃疡出血的重要危险因素。在《药物性消化性溃疡临床指南》修订版中，推荐了两条关于根除（）的声明。1）计划接受长期NSAID治疗的患者应检测并治疗（）感染，以预防PU及其并发症。2）有PU病史且接受长期低剂量阿司匹林（LDA）治疗的患者应接受（）感染治疗，以预防PU及其并发症。另一方面，与未使用过NSAID的患者不同，根除（）对慢性NSAID使用者的预防效果尚不清楚。此外，对于一部分长期LDA使用者，尤其是正在服用抗血小板药物或抗凝剂的患者，根除（）后可能需要使用质子泵抑制剂等抗溃疡药物进行维持治疗。
