[18]用甲硝唑800mL·d-1治疗13例继续服用NSAIDs的患者12周,结果显示所有患者肠道炎症显著减轻,且58%患者铟排泄量恢复到正常水平。近年研究显示,质子泵抑制药对NSAIDs肠病有治疗作用,可能与其增强肠道屏障功能、抑制中性粒细胞有关。Mizoguch[19]研究发现,瑞巴匹特可减少NSAIDs引起大鼠小肠损害,可能与抑制中性粒细胞激活,减少氧自由基有关。而Niwa采用胶囊内镜观察发现,瑞巴匹特有治疗健康受试者服用NSAIDs引起小肠损害作用。
综上所述,随着NSAIDs的广泛应用,胃肠道不良反应日渐突出,特别是NSAIDs肠道损害,由于人们对其没有足够的认识,常因漏诊或误诊而延误病情。因此,临床应该关注NSAIDs对胃肠道的不良反应,特别是老年人和需长期服用的患者。另外应加强对NSAIDs肠病的药物治疗研究,以期对NSAIDs肠病更好的治疗。
【参考文献】
[1]Bjamason I,Price AB,Zanelli G,et al. Clinicopathological featuresof nonsteroidal antiinflammatory druginduced small intestinalstrictures[J]. Gastroenterology,1988,94:10701074.
[2]Anthony A,Pounder RE,Dhill0n AP,el al. Vascular anatomy defines sites of indomethacin induced jejunal ulceration along the mesenteric margin[J]. Gut,1997,41(6):763770.
[3]Nygard G,Anthoy A,Piasecki c,el al. Acute indomethacininduced jejunal injury in the rat:early morphological and biochemical changes[J]. Gastroenterology,1994,106:567575.
[4]Anthony A,Bah1 AK,Oakley IG,et al. The beta 3adrenoceptor agonist CL316243 prevents indomethacininduced jejunal ulceration in the rat by reversing early villous shortening[J]. J Pathol,1996,179(3):340346.
[5]Kelly DA;Piasecki C;Anthony A,el al. Focal reduction of villous blood flow in early indomethacin enteropathy:a dynamic vascular study in the rat[J]. Gut,1998,42(3):366373.
[6]Reuter BK. Davies NM,Wallace JL. Nonsteroidal antiinflammatory drug enteropathy in rats:role of permeability,bacteria,and enterohepatic circulation[J]. Gastroenterology,1997,112(1):109117.
[7]Koga H,Aoyagi K,Matsumoto T,et al. Experimental enteropathy in athymic and euthymic rats:synergistic role of lipopolysaccharide and indomethacin[J]. Am J Physiol 1999,276:G576582.
[8]Kumura RE,Dy SA,Umng MR,el al. The effects of highDose Ibuprofen and pancreatic enzymes on the intestine of the rat[J]. J Pediatr gastroenterolgy,1999,29(2):178183.
[9]Smith T,Bjarnmson I. Experience with a gas
上一页 [1] [2] [3] [4] [5] 下一页