Royal Hallamshire Hospital, Sheffield, UK
Royal Hallamshire Hospital, Sheffield, UK.
Clin Med (Lond). 2021 Mar;21(2):131-134. doi: 10.7861/clinmed.2021-0039.
Non-steroidal anti-inflammatory drugs (NSAIDs) are used commonly but can cause foregut symptoms, peptic ulcer disease and small bowel enteropathy. Such iatrogenic injury can be complicated by gastrointestinal bleeding and perforation. Limiting NSAID use or co-administration with proton pump inhibitors (PPIs) reduce dyspepsia, peptic ulcer disease and rates of complications. Selective cyclo-oxygenase (COX)-2 inhibitors are as effective as adding PPIs in preventing upper and lower gastrointestinal complications. COX-2 inhibitors are suggested in those with high cardiovascular risk and the addition of PPI in those with high risk of bleeding. Where required, COX-2 inhibitor monotherapy may be preferred in unexplained iron deficiency anaemia.
非甾体抗炎药（NSAIDs）应用广泛，但可引起前胃肠道症状、消化性溃疡病和小肠肠病。这种医源性损伤可导致胃肠道出血和穿孔等并发症。限制 NSAID 的使用或与质子泵抑制剂（PPIs）联合应用可减少消化不良、消化性溃疡病和并发症的发生率。选择性环氧化酶（COX）-2 抑制剂与加用 PPI 一样有效预防上、下胃肠道并发症。建议心血管高危人群使用 COX-2 抑制剂，高危出血人群加用 PPI。在有需要的情况下，对于不明原因缺铁性贫血，可首选 COX-2 抑制剂单药治疗。
