非甾体抗炎药的胃肠损害及其预防  

NSAIDs-induced gastrointestinal injury and its prevention

作　　者：张文燕[1] 袁耀宗[1] 

机构地区：[1]上海交通大学附属瑞金医院消化科,上海200025

出　　处：《药物不良反应杂志》2008年第3期190-194,共5页Adverse Drug Reactions Journal

摘　　要：非甾体抗炎药(NSAIDs)在临床上广泛用于风湿性疾病及心血管疾病的治疗。NSAIDs的常见不良反应为胃肠道不适、恶心,严重不良反应有消化性溃疡、胃肠道出血或穿孔。胃肠损伤发生的原因是由于NSAIDs抑制了环氧酶(COX)系统而阻断了前列腺素的合成,因此干扰了正常黏膜保护机制导致局部受损。NSAIDs致胃肠道损伤的危险因素为高龄、有消化性溃疡或出血史。预防NSAIDs所致胃肠损伤的措施有:应用预防溃疡的药物,选择新一代高选择性COX-2抑制剂,根据患者情况应用抗幽门螺杆菌疗法,依据患者相关的危险因素采用不同的治疗方案。Non-steroidal anti-inflammatory drugs （NSAIDs） are widely used for treatment of rheumatic and cardiovascular diseases in clinical practice. The most common adverse reactions to NSAIDs are gastrointestinal discomfort, nausea, and severe reactions are peptic ulcer, gastrointestinal bleeding or perforation, The pathogenesis of gastrointestinal injury is that NSAIDs inhibit COX enzyme system, thus blocking the prostaglandin synthesis; in turn, interferes with normal mucosal protective mechanisms, leading to local injury, The risk factors for gastrointestinal injury induced by NSAIDs are old age, a history of peptic ulcers or bleeding of gastrointestinal tract, Ways of preventing NSAlDs-induced gastrointestinal injury include the use of ulcer-preventing drugs, the choice of new hlgh-selective COX-2 inhibitors, the use of anti-Hellcobacter pylori therapy according the patient＇s condition, and taking different therapeutic programs based on patient-related risk factors.

关 键 词：非甾体抗炎药 胃肠损伤 预防 

分 类 号：R971.1[医药卫生—药品]