|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Clinical features of gastroduodenal injury associated with long-term low-dose aspirin therapy显示文摘Low-dose aspirin(LDA) is clinically used for the prevention of cardiovascular and cerebrovascular events with the advent of an aging society.On the other hand,a very low dose of aspirin(10 mg daily) decreases the gastric mucosal prostaglandin levels and causes significant gastric mucosal damage.The incidence of LDAinduced gastrointestinal mucosal injury and bleeding has increased.It has been noticed that the incidence of LDA-induced gastrointestinal hemorrhage has increased more than that of non-aspirin non-steroidal anti-inflammatory drug(NSAID)-induced lesions.The pathogenesis related to inhibition of cyclooxygenase(COX)-1 includes reduced mucosal flow,reduced mucus and bicarbonate secretion,and impaired platelet aggregation.The pathogenesis related to inhibition of COX-2 involves reduced angiogenesis and increased leukocyte adherence.The pathogenic mechanisms related to direct epithelial damage are acid back diffusion and impaired platelet aggregation.The factors associated with an increased risk of upper gastrointestinal(GI) complications in subjects taking LDA are aspirin dose,history of ulcer or upper GI bleeding,age > 70 years,concomitant use of non-aspirin NSAIDs including COX-2-selective NSAIDs,and Helicobacter pylori(H.pylori) infection.Moreover,no significant differences have been found between ulcer and non-ulcer groups in the frequency and severity of symptoms such as nausea,acid regurgitation,heartburn,and bloating.It has been shown that the ratios of ulcers located in the body,fundus and cardia are significantly higher in bleeding patients than the ratio of gastroduodenal ulcers in patients taking LDA.Proton pump inhibitors reduce the risk of developing gastric and duodenal ulcers.In contrast to NSAIDinduced gastrointestinal ulcers,a well-tolerated histamine H2-receptor antagonist is reportedly effective in prevention of LDA-induced gastrointestinal ulcers.The eradication of H.pylori is equivalent to treatment with omeprazole in preventing recurrent bleeding.Continuous aspirin therapy for patients with gastrointestinal bleeding may increase the risk of recurrent bleeding but potentially reduces the mortality rates,as stopping aspirin therapy is associated with higher mortality rates.It is very important to prevent LDA-induced gastroduodenal ulcer complications including bleeding,and every effort should be exercised to prevent the bleeding complications. | Junichi Iwamoto Yoshifumi Saito Akira Honda Yasushi Matsuzaki | 2013 | World Journal of Gastroenterology2013，19，11： | 29 |
| 2 | 2型糖尿病合并消化性溃疡患者治疗的临床研究显示文摘目的探讨2型糖尿病合并消化性溃疡患者的临床特点。方法以我院消化内科收治的78例2型糖尿病合并消化性溃疡患者作为研究对象,将其设为观察组,另选78例非2型糖尿病合并消化性溃疡患者作为对照组进行研究,两组治疗方法相同,对比分析两组患者临床症状、溃疡大小,及其治疗效果等。结果观察组恶心反酸、上腹疼痛、腹胀情况明显高于对照组,各溃疡面积比例高于对照组,差异显著(P<0.05),其他症状相比,无显著差异(P>0.05);治疗后,观察组治疗总有效率为83.3%、幽门螺杆菌(H.pylori)根除率为34.6%,明显低于对照组的96.2%、66.7%,差异显著(P<0.05)。结论 2型糖尿病合并消化性溃疡患者与非2型糖尿病合并消化性溃疡患者相比存在较多的不同,其溃疡范围更大,且治疗后H.pylori根除效果不佳。临床治疗时应根据其临床症状及特点,制定合理的治疗方案,减轻患者的痛苦。 | 郝尧 | 2015 | 现代消化及介入诊疗2015，20，4： | 17 |
| 3 | Poor awareness of preventing aspirin-induced gastrointestinal injury with combined protective medications显示文摘AIM:To investigate prescribing pattern in low-dose aspirin users and physician awareness of preventing aspirin-induced gastrointestinal(GI) injury with combined protective medications.METHODS:A retrospective drug utilization study was conducted in the 2nd Affiliated Hospital,School of Medicine,Zhejiang University.The hospital has 2300 beds and 2.5 million outpatient visits annually.Data mining was performed on all aspirin prescriptions for outpatients and emergency patients admitted in 2011.Concomitant use of proton-pump inhibitors(PPIs),histamine 2-receptor antagonists(H2RA) and mucoprotective drugs(MPs) were analyzed.A defined daily dose(DDD) methodology was applied to each MP.A further investigation was performed in aspirin users on combination use of GI injurious medicines [non-steoid anti-inflammatory drugs(NSAIDs),corticosteroids and clopidogrel and warfarin] or intestinal protective drugs(misoprostol,rebamipide,teprenone and gefarnate).Data of major bleeding episodes were derived from medical records and adverse drug reaction monitoring records.The annual incidence of major GI bleeding due to low-dose aspirin was estimated for outpatients.RESULTS:Prescriptions for aspirin users receiving PPIs,H2RA and MPs(n = 1039) accounted for only 3.46% of total aspirin prescriptions(n = 30 015).The ratios of coadministration of aspirin/PPI,aspirin/H2RA,aspirin/MP and aspirin/PPI/MP to the total aspirin prescriptions were 2.82%,0.12%,0.40% and 0.12%,respectively.No statistically significant difference was observed in age between patients not receiving any GI protective medications and patients receiving PPIs,H2RA or MPs.The combined medication of aspirin and PPI was used more frequently than that of aspirin and MPs(2.82% vs 0.40%,P < 0.05) and aspirin/H2RA(2.82% vs 0.12%,P < 0.05).The values of DDDs of MPs in descending order were as follows:gefarnate,hydrotalcite > teprenone > sucralfate oral suspension > L-glutamine and sodium gualenate granules > rebamipide > sucralfate chewable tablets.The ratio of MP plus aspirin prescriptions to the total MP prescriptions was as follows:rebamipide(0.47%),teprenone(0.91%),L-glutamine and sodium gualenate granules(0.92%),gefarnate(0.31%),hydrotalcite(1.00%) and sucralfate oral suspension(0.13%).Percentages of prescriptions containing aspirin and intestinal protective drugs among the total aspirin prescriptions were:rebamipide(0.010%),PPI/rebamipide(0.027%),teprenone(0.11%),PPI/teprenone(0.037%),gefarnate(0.017%),and PPI/gefarnate(0.013%).No prescriptions were found containing coadministration of aspirin and other NSAIDs.Among the 3196 prescriptions containing aspirin/clopidogrel,3088(96.6%) prescriptions did not contain any GI protective medicines.Of the 389 prescriptions containing aspirin/corticosteroids,236(60.7%) contained no GI protective medicines.None of the prescriptions using aspirin/warfarin(n = 22) contained GI protective medicines.Thirty-five patients were admitted to this hospital in 2011 because of acute hemorrhage of upper digestive tract induced by low-dose aspirin.The annual incidence rates of major GI bleeding were estimated at 0.25% for outpatients taking aspirin and 0.5% for outpatients taking aspirin/warfarin,respectively.CONCLUSION:The prescribing pattern of low-dose aspirin revealed a poor awareness of preventing GI injury with combined protective medications.Actions should be taken to address this issue. | Ling-Ling Zhu Ling-Cheng Xu Yan Chen Quan Zhou Su Zeng | 2012 | World Journal of Gastroenterology2012，18，24： | 9 |
| 4 | 阿司匹林对胃肠黏膜的损伤作用显示文摘阿司匹林被广泛应用于心脑血管血栓性事件(心绞痛、心肌梗死、缺血性脑卒中等)的预防。然而,许多大型临床试验表明长期服用阿司匹林会引起胃肠黏膜损伤,即使低剂量阿司匹林亦会引起胃十二指肠黏膜损伤。本文就阿司匹林对胃肠黏膜的影响及其机制作一概述。 | 冯雯 范一宏 吕宾 | 2011 | 胃肠病学2011，16，1： | 9 |
| 5 | 抗血小板治疗导致胃肠道损伤及其防治的研究进展显示文摘抗血小板药物治疗是进行心脑血管疾患预防及治疗的基石,广泛应用于临床.但长期使用可造成胃肠道损害,导致消化道出血等严重不良事件发生.如何在抗血小板治疗的同时进行消化系不良反应的防治,是目前临床面临的重要问题.本文就常用抗血小板药物阿司匹林和氯吡格雷导致胃肠道损害的作用机制、特点、防治措施等相关问题进行阐述,并对抗血小板药物相关消化道出血诊治指南和专家共识介绍. | 蓝宇 路国涛 | 2012 | 世界华人消化杂志2012，20，17： | 8 |
| 6 | 消化性溃疡史患者中小剂量阿司匹林相关的胃肠损伤预防性治疗的系统评价与Meta分析显示文摘目的验证质子泵抑制剂(PPIs)和对照药物在长期服用低剂量阿司匹林(LDA)且有消化性溃疡病史的患者中相关胃肠道损伤的预防效果,以减少PPIs在预防用药方面的滥用。方法检索了PubMed、Cochrane图书馆和Embase数据库,更新至2018年5月,收集用于评估预防性治疗[PPIs,H_2受体拮抗剂(H2RA),沃诺拉赞(Vonoprazan)和胃黏膜保护剂]对长期应用LDA引起的胃肠道损伤的疗效的随机对照试验。结果纳入9项研究,共3067例患者。结果显示,PPIs在预防溃疡复发和上消化道出血方面的效果均优于安慰剂和胃黏膜保护剂;Vonoprazan(OR=2.61,95%CI:0.81~8.41)和H_2RA(OR=0.36,95%CI:0.04~3.54)在预防消化性溃疡复发方面与PPIs疗效相似,而在预防上消化道出血方面,Vonoprazan的预防效果优于PPIs,H_2RA的预防效果不如PPIs。在感染幽门螺杆菌引起上消化道出血史的患者中,幽门螺杆菌根除治疗与PPIs具有相似的预防效果(OR=0.50, 95%CI:0.04~5.54)。结论 H_2RA和Vonoprazan在预防消化性溃疡复发方面与PPIs疗效相似,而Vonoprazan在预防溃疡出血方面的效果优于PPIs,且在感染幽门螺杆菌的患者中,根除治疗与PPIs具有相似的预防效果。因此PPIs可能并不是预防消化性溃疡史患者中LDA相关的胃肠损伤的最佳选择。 | 万宁 张田甜 董艳敏 杨晨 季波 | 2019 | 中国医药导报2019，16，3： | 7 |
| 7 | 小剂量阿司匹林所致消化道损伤防治状况调查显示文摘目前,小剂量阿司匹林(low-doseaspirin,LDA,75-325mg/d)已被大量循证医学证实具有抗血小板作用,临床上被广泛应用于心脑血管病的一级、二级预防。但其导致的消化道不良反应,甚至致命性的消化道损伤,如上}肖化道大出血等逐渐引起人们的关注,但仍未引起临床医师,尤其是使用LDA医师的广泛重视,消化道损伤的防治状况不容乐观。为了解服用LDA患者消化道损伤防治情况,我们对服用LDA的患者进行调查分析,以期对指导临床实践有所帮助。一。 | 路国涛 蓝宇 阴英 程远 | 2013 | 中华内科杂志2013，52，3： | 6 |
| 8 | 冠心病双重抗血小板治疗导致消化道出血的预防策略显示文摘联合应用氯吡格雷与阿司匹林双重抗血小板治疗能够进一步降低冠心病及支架置入后患者发生血栓事件的风险。但是,双重抗血小板治疗也增加消化道出血的风险。本文就冠心病患者双重抗血小板治疗的必要性、需要双重抗血小板治疗的人群、双重抗血小板治疗导致消化道出血的发病机制及流行病学现状及如何预防双重抗血小板治疗导致的消化道出血等进行系统叙述。 | 莫晨 陈韵岱 杨云生 | 2015 | 中国急救复苏与灾害医学杂志2015，0，8： | 6 |
| 9 | 消化性溃疡与非甾体抗炎药的合理应用显示文摘目的:评估非甾体抗炎药(NSAID)致溃疡的作用及合理应用NSAIDs。方法:全面复习与NSAID相关的不良反应及有用的防治理念的文献,基于作者就此领域的专家评论并补充近15年截止于2010年4月在PubMed用英文发表的研究论文。结果:与NSAIDs治疗增加上消化道并发症风险的相关因素包括:NSAID剂量、消化性溃疡病史或上消化道出血史、年龄>65岁、同时使用多种NSAID药物、幽门螺杆菌(Hpylori)感染。联用质子泵抑制剂(PPI)对减轻上消化道副作用有益,根除H pylori(特别是对有高风险者)也可降低此类副作用风险。结论:应用NSAIDs,COX-2抑制剂、阿司匹林和其它的抗凝剂对处理消化性溃疡出血提出新的挑战。内镜诊治应是一线处理方法。联合应用强力抑酸剂可增强保护作用,有利于控制出血。根除幽门螺杆菌无疑是重要的策略。权衡使用这类药的获益和风险是最重要的原则。 | 杨昭徐 | 2010 | 药品评价2010，7，16： | 4 |
| 10 | H_2受体拮抗剂预防低剂量阿司匹林相关上消化道损伤的研究显示文摘随着低剂量阿司匹林(LDA)在心脑血管疾病一级预防及二级预防中的广泛应用,LDA相关上消化道损伤的发病率逐年增加。质子泵抑制剂(PPI)能够有效预防LDA相关的上消化道损伤,但长期应用PPI的不良反应、价格及其与氯吡格雷的相互作用,使PPI的预防作用受到质疑。传统的抑酸药物H2受体拮抗剂(H2RA)再次受到关注。该文就H2RA对LDA相关上消化道损伤的预防效果及与PPI的疗效比较予以综述。 | 莫晨 徐铭宝 | 2015 | 医学综述2015，21，14： | 1 |
| 11 | 不同时间口服阿司匹林所致消化道损伤的临床观察显示文摘目的:探讨不同时间口服阿司匹林所致的消化道损伤。方法:以我院2008年7月1日-2012年6月30日,口服阿司匹林进行心脑血管病的一级、二级预防的门诊或住院患者2386人作为研究对象,随机分为晨间空腹口服组(晨服组1204人)和晚间睡前口服组(晚服组1180人),并记录核实患者提供的基本信息,以及口服阿司匹林后出现的消化道不良反应状况。结果:晨服组254例出现消化道不良反应,占21.1%,其中消化道出血33例,占2.74%;晚服组405例出现消化道不良反应,占34.26%,其中消化道出血86例,占7.36%;两组具有显著差异性(P<0.05)。结论:晨间口服阿司匹林可明显降低少消化道不良反应的发生率;尤其显著降低消化道出血的发生率。 | 郑俊华 唐浩然 景丽英 罗琼珍 | 2014 | 深圳中西医结合杂志2014，24，3： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员