Rösch W
Medizinische Klinik am Krankenhaus Nordwest der Stiftung Hospital, Frankfurt am Main.
Z Rheumatol. 1995 Jan-Feb;54(1):2-8; discussion 9-11.
There is a lot of epidemiological information to calculate the risk of developing gastroduodenal lesions during NSAID therapy on a reliable base in an individual patient. In treating NSAID ulcers one has to decide whether the antirheumatic treatment can be stopped or whether one has to continue. In the first mentioned condition all antiulcer drugs can be used safely like in chronic recurrent ulcer disease. However, when NSAID therapy has to be continued proton pump inhibitors are necessary in doubled therapeutic dosage. Prophylaxis should not be made in all patients on NSAIDs, but is only indicated with convincing cost-benefit ratio in high-risk patients. Whereas H2-blockers and proton pump inhibitors seem to protect mainly the duodenal mucosa oral prostaglandins (Misoprostol) are effective in the stomach as well.
有大量的流行病学信息可用于在可靠的基础上计算个体患者在非甾体抗炎药治疗期间发生胃十二指肠病变的风险。在治疗非甾体抗炎药溃疡时，必须决定抗风湿治疗是否可以停止，或者是否必须继续。在上述第一种情况下，所有抗溃疡药物都可以像治疗慢性复发性溃疡病一样安全使用。然而，当必须继续使用非甾体抗炎药治疗时，质子泵抑制剂需要加倍治疗剂量。并非所有服用非甾体抗炎药的患者都需要进行预防，只有在高危患者中，当成本效益比令人信服时才需要预防。H2受体阻滞剂和质子泵抑制剂似乎主要保护十二指肠黏膜，而口服前列腺素（米索前列醇）对胃也有效。
