非类固醇抗炎药物诱导的胃潰瘍疾病
1Department of Gastroenterology, Daejeon Eulji University Hospital, Eulji University College of Medicine, Daejeon, Korea.
概括
长时间使用非类固醇抗炎药物 (NSAIDs) 会导致胃潰瘍疾病 (PUD). 风险分层,质子抑制剂和NSAID中止是预防和治疗NSAID诱导的PUD的关键.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 非类固醇抗炎药物 (NSAIDs) 通常用于治疗疼痛和炎症.
- 长期使用NSAID是导致胃潰瘍疾病 (PUD) 和其并发症,包括出血和穿孔的主要原因.
- NSAID诱导的PUD病变包括循环氧化酶 (COX) 抑制和直接的粘膜损伤,损害胃肠道防御.
研究的目的:
- 审查NSAID引起的PUD的流行病学,发病因子,风险因素和管理策略.
- 强调风险分层和预防措施在管理NSAID使用中的重要性.
- 讨论目前和新兴的NSAID诱导的PUD治疗方案.
主要方法:
- 对NSAID诱导的PUD的流行病学研究和临床试验的系统审查.
- 风险因素的分析,包括年龄,病史和同时服用药物.
- 评估预防和治疗药物的疗效,如质子抑制剂 (PPI) 和选择性COX-2抑制剂.
主要成果:
- 在NSAID诱导的PUD患病率存在显著的地理差异,由于预防策略,高收入国家的发病率较低.
- 诸如晚年,先前的和使用抗凝剂/皮质类固醇等危险因素会增加的风险.
- 质子抑制剂 (PPI) 在预防和治疗方面非常有效; 停用NSAID可以提高愈合率.
结论:
- 谨慎的风险分层,考虑到胃肠道和心血管风险,对于NSAID处方至关重要.
- 质子抑制剂 (PPI) 和潜在的竞争性酸阻塞剂提供有效的预防和治疗.
- 解决Helicobacter pylori感染和优化预防策略对于管理NSAID诱导的PUD至关重要.
相关概念视频
01:30Peptic Ulcer Disease I: Introduction
302
Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
302
01:20Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
603
The gastric mucosa produces prostaglandins E2 (PGE2) and prostacyclin (PGI2), crucial in maintaining gastric health. They exert cytoprotective effects, including increasing bicarbonate secretion, releasing protective mucin, reducing gastric acid output, and preventing harmful vasoconstriction. These effects are mediated through various receptors, such as EP1, EP2, EP3, and EP4.
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
603
01:13Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
534
Peptic ulcers, often induced by H. pylori infections or NSAID usage, arise from disruptions in the delicate balance of gastric acid production. Peptic ulcers stem from heightened gastric acid levels due to H. pylori infections or NSAID use. The protective mucus layer diminishes in the presence of these factors, allowing gastric acid to erode the stomach lining and form ulcers.
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
534
01:24Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors
604
Peptic ulcer disease, commonly called PUD, represents a multifaceted condition characterized by disruptions in the lining of the gastrointestinal (GI) tract. Central to the protection of the gastrointestinal lining is the mucosal-bicarbonate barrier. This physiological defense mechanism is a formidable shield against the corrosive effects of gastric acid and pepsin secretion in the stomach. Its role is pivotal in maintaining the structural integrity of the stomach's inner lining.
604
01:26Peptic Ulcer Disease IV: Management
150
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
150
01:22Pathophysiology of Peptic Ulcer Disease: Injurious Factors
728
Peptic ulcers are sores on the stomach's inner lining and the upper small intestine, which are the result of disruptions in the mucosal layer that houses parietal cells which produce gastric acid, and chief cells which secrete pepsinogen.
In the antrum region, G cells secrete the gastrin hormone that binds to gastrin-cholecystokinin-B (CCK2) receptors on parietal and enterochromaffin-like (ECL) cells in the fundic glands. Simultaneously, the vagus nerve releases acetylcholine, which binds...
In the antrum region, G cells secrete the gastrin hormone that binds to gastrin-cholecystokinin-B (CCK2) receptors on parietal and enterochromaffin-like (ECL) cells in the fundic glands. Simultaneously, the vagus nerve releases acetylcholine, which binds...
728