Perret G
Rev Pneumol Clin. 1985;41(2):139-44.
It is generally accepted that glucocorticoids are ulcerogenic. The different pharmacological, biological and clinical arguments on which this opinion is founded are reviewed. It is concluded that, particularly in pneumology, none of them is sufficiently sound to justify the prophylactic measures generally systematically used. In fact it appears that glucocorticoids are not primary offenders by rather potentiate ulcerogenesis. Prophylactic measures are therefore indicated only in ulcerogenic conditions such as association with non steroidal anti-inflammatory agents or in some pathological situations such as rheumatoid arthritis and severe cirrhosis. These conditions are generally not encountered in pneumology and therefore the ulcerogenic risk in this case can be considered as non existent.
一般认为糖皮质激素具有致溃疡作用。本文回顾了支持这一观点的不同药理学、生物学及临床依据。得出的结论是,尤其在肺病学领域,这些依据均不足以充分支持普遍系统采用的预防措施。事实上,糖皮质激素似乎并非主要致溃疡因素,而是会增强溃疡形成过程。因此,仅在诸如与非甾体类抗炎药联用等致溃疡情况下,或在类风湿关节炎及严重肝硬化等某些病理状况下才需采取预防措施。而这些情况在肺病学中通常不会遇到,所以在这种情况下可认为不存在致溃疡风险。