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非甾体抗炎药诱发肠病的诊治

[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】

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  [9]Smith T,Bjarnmson I. Experience with a gas

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