Singh G, Rosen Ramey D
Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA.
J Rheumatol Suppl. 1998 May;51:8-16.
Gastrointestinal (GI) complications related to nonsteroidal antiinflammatory drug (NSAID) therapy are the most prevalent category of adverse drug reactions. Patients with arthritis are among the most frequent users of NSAID and are therefore particularly at risk for these side effects. To evaluate the nature of NSAID related GI complications and to determine how their frequency can be reduced, a series of studies of such complications in patients with rheumatic disease has been carried out based on data from the Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS). We review the literature and present findings from the ARAMIS studies. This report addresses whether GI side effects such as dyspepsia can serve as warning symptoms for serious GI complications and describes the risk factors for these life threatening complications. It also describes differences among NSAID with regard to their GI toxicity and describes a study that investigated whether H2-receptor antagonists and antacids affect the development of serious GI complications. In addition, ongoing research and topics to be addressed in future studies are described.
与非甾体抗炎药（NSAID）治疗相关的胃肠道（GI）并发症是最常见的药物不良反应类型。关节炎患者是NSAID的最频繁使用者之一，因此特别容易出现这些副作用。为了评估与NSAID相关的GI并发症的性质，并确定如何降低其发生率，基于关节炎、风湿病和衰老医学信息系统（ARAMIS）的数据，对风湿病患者的此类并发症进行了一系列研究。我们回顾了文献并展示了ARAMIS研究的结果。本报告探讨了诸如消化不良等GI副作用是否可作为严重GI并发症的警示症状，并描述了这些危及生命并发症的风险因素。它还描述了不同NSAID在GI毒性方面的差异，并描述了一项研究，该研究调查了H2受体拮抗剂和抗酸剂是否会影响严重GI并发症的发生。此外，还描述了正在进行的研究以及未来研究中要解决的课题。
