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现已确认胃肠道粘膜损伤和非甾体抗炎药(NSAIDs)之联系,有15—20%病人发生溃疡病,其中3%继而出血或穿孔,主要在一些高危组病人中并发,包括老年女性、有溃疡病或胃肠出血史、饮酒及服抗凝药者.近报告一些新NSAIDs如萘丁美酮(Na bumetone,NB)和依托度酸(萘普生Etodolac,E)、丙嗪(Oxaprogin,OX)等,它们选择性抑制靶组织(不包括胃)前列腺素的合成,在临床应用较为安全.其中英国对NB上市后12个月的调查,10800例风湿性关节炎或骨关节炎患者服用NB,仅11例有严重副作用(0.1%),其中7例为胃肠出血;德国8865例服用NB的关节炎病人中,也仅2例胃肠出血,但美国1912例关节炎病人服用NB后13例发现溃疡.奈普生(E):72例正常志愿者经内镜观察1周,E比布洛芬、吲哚美辛病变显著轻,与安慰剂组相似.48例风湿性关节炎病人以内镜观察服E有明显胃粘膜损伤为15%,用NP为46%.法国4947例风
It has now been confirmed that gastrointestinal mucosal injury is associated with non-steroidal anti-inflammatory drugs (NSAIDs), and 15-20% of patients develop ulcers, of which 3% subsequently hemorrhage or perforation, mainly in some high-risk patients, including elderly Women who have had a history of ulcer disease or gastrointestinal bleeding, drinking and taking anticoagulants have recently reported some new NSAIDs such as Na bumetone (NB) and etodolac (Naproxen), promethazine (Oxaprogin, OX), which selectively inhibit the synthesis of prostaglandins in the target tissue (not including the stomach), which is safer in clinical practice.Among them, the British survey of 12 months after the listing of NB, 10800 cases of rheumatoid arthritis or bone and joint Inflammation patients taking NB, only 11 cases had serious side effects (0.1%), of which 7 cases of gastrointestinal bleeding; Germany 8865 patients taking NB arthritis patients, only 2 cases of gastrointestinal bleeding, but the United States 1912 cases of arthritis patients Thirty-one cases of ulcers were found after NB was taken Naproxen (E): 72 cases of normal volunteers were observed by endoscopy for 1 week, E-ibuprofen and indomethacin lesions were significantly lighter, similar to the placebo group .48 cases of rheumatic Arthritis patients with endoscopic observation service E significant gastric mucosal injury was 15% with NP was 46% France 4947 cases of wind