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| 1 | 阿司匹林应用于肿瘤患者的研究进展显示文摘阿司匹林是常见的非甾体类抗炎药(NSAID),主要作用为解热、镇痛、抗炎,主要作用机制为抑制环氧化酶(COX)活性,通过激活死亡受体(DR)而诱导细胞凋亡,抑制细胞核因子κB(NF-κB)合成等。近年来,阿司匹林在抗肿瘤治疗方面的应用受到越来越广泛的关注,其可预防多种癌症的发生,降低癌症发生率,还可抑制肿瘤细胞生长,和其他药物联合应用可起到抗肿瘤作用,也可提高癌细胞对放、化疗的敏感性。此外,阿司匹林还能有效抑制血小板聚集,改善肿瘤患者的血液高凝高黏状态,预防血栓形成,降低肿瘤患者发生栓塞的危险性。 | 马丽丽 赵丽萍 | 2013 | 中国全科医学2013，16，30： | 13 |
| 2 | 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 |
| 3 | 胶囊内镜对非甾体类抗炎药致小肠黏膜损伤的诊断价值研究显示文摘目的探讨胶囊内镜对无典型临床表现的非甾体类抗炎药(NSAID)致小肠黏膜损伤的诊断价值。方法纳入2006年10月至2013年12月进行胶囊内镜检查患者110例,其中服用NSAID者38例,比较NSAID服用者与不服用者、服药持续时间≥3个月者与〈3个月者、服用低剂量阿司匹林者与服用非阿司匹林NSAID者的小肠黏膜损伤的发现率,以及小肠黏膜损伤发生的部位和随访情况。结果小肠黏膜损伤发现率服药组为55.3%(21/38),未服药组为5.6%(4/72),2组差异有统计学意义(P〈0.01);服药持续时间≥3个月者小肠黏膜损伤发现率显著高于服药持续时间〈3个月者(7/24比4/14,P=0.01);服用非阿司匹林NSAID者小肠黏膜损伤发现率显著高于服用低剂量阿司匹林者(11/14比10/24,P〈0.05)。在服用低剂量阿司匹林的患者中,服药持续时间≥3个月者小肠黏膜损伤发现率显著高于服药持续时间〈3个月者(10/16比0/8,P=0.00)。服用NSAID者小肠黏膜溃疡主要发生在回肠(10/11),而小肠黏膜糜烂主要发生在空肠(8/10)。8例小肠溃疡患者在停服NSAID或加用黏膜保护剂后,复查胶囊内镜显示小肠溃疡明显改善;4例小肠黏膜糜烂患者加用黏膜保护剂后,复查胶囊内镜显示小肠黏膜糜烂基本消失。结论胶囊内镜对无典型临床表现的NSAID致小肠黏膜损伤具有较好的诊断及指导治疗的作用。 | 薄陆敏 杨俊驰 廖专 徐灿 辛磊 陈洁 方艾乔 李兆申 | 2015 | 中华消化内镜杂志2015，32，1： | 9 |
| 4 | 质子泵抑制药加重非甾体抗炎药所致小肠损伤及其防治措施的文献综述显示文摘质子泵抑制药(PPIs)可有效治疗胃和十二指肠的损伤出血,但对非甾体抗炎药(NSAIDs)所致小肠损伤效果不佳,甚至加重损伤的程度。PPIs通过改变肠道菌群和增加胆汁酸的细胞毒性等机制加重NSAIDs药物引起的小肠损伤,联合用药前应充分评估患者的获益及风险,治疗时需兼顾上下消化道,可选用具消化道黏膜保护功能的特殊组胺H2受体拮抗药如拉呋替丁;尽可能选用对消化道影响较小的NSAIDs药物如选择性COX-2抑制药;补充肠道益生菌,纠正肠道微生态;使用消化道黏膜保护药物;必要时使用肠道的局部抗菌药。考虑到COX-2抑制药和PPIs的心血管风险,对于患有心脑血管疾病和存在心脑血管疾病风险的患者,应慎用此两类药物。 | 金晶 谭诗云 方向明 | 2019 | 药物流行病学杂志2019，28，7： | 4 |
| 5 | Sodium alginate ameliorates indomethacin-induced gastrointestinal mucosal injury via inhibiting translocation in rats显示文摘AIM:To investigate the effects of sodium alginate(ALNa)on indomethacin-induced small intestinal lesions in rats.METHODS:Gastric injury was assessed by measuring ulcerated legions 4 h after indomethacin(25 mg/kg)administration.Small intestinal injury was assessed by measuring ulcerated legions 24 h after indomethacin(10mg/kg)administration.AL-Na and rebamipide were orally administered.Myeloperoxidase activity in the stomach and intestine were measured.Microvascular permeability,superoxide dismutase content,glutathione peroxidase activity,catalase activity,red blood cell count,white blood cell count,mucin content and enterobacterial count in the small intestine were measured.RESULTS:AL-Na significantly reduced indomethacininduced ulcer size and myeloperoxidase activity in the stomach and small intestine.AL-Na prevented increases in microvascular permeability,superoxide dismutase content,glutathione peroxidase activity and catalase activity in small intestinal injury induced by indomethacin.AL-Na also prevented decreases in red blood cells and white blood cells in small intestinal injury induced by indomethacin.Moreover,AL-Na suppressed mucin depletion by indomethacin and inhibited infiltration of enterobacteria into the small intestine.CONCLUSION:These results indicate that AL-Na ameliorates non-steroidal anti-inflammatory drug-induced small intestinal enteritis via bacterial translocation. | Atsuki Yamamoto Tomokazu Itoh Reishi Nasu Ryuichi Nishida | 2014 | World Journal of Gastroenterology2014，20，10： | 1 |
| 6 | 瑞巴派特治疗NSAIDs相关性胃肠道不良反应疗效的Meta分析显示文摘目的评价瑞巴派特治疗NSAIDs相关性胃肠道不良反应的临床疗效。方法计算机检索PubMed、Medline、EMBASE、The Cochrane Library,中国生物医学文献数据库(CBM)、中国知网(CNKI)和万方数据库(WanFang Data)发表的有关瑞巴派特治疗NSAIDs相关性胃肠道不良反应的随机对照试验。2名评价者独立对纳入文献进行质量评价和数据提取,应用RevMan5.3进行数据分析。结果纳入11篇研究共计466例研究对象,包括138例健康志愿者。Meta分析结果显示:在NSAIDs相关性胃肠道症状(OR=0.34,95%CI:0.19~0.58)方面,瑞巴派特较安慰剂改善明显,差异具有统计学意义(P<0.05);瑞巴派特对NSAIDs导致的轻度胃粘膜损伤(OR=1.29,95%CI:0.29~4.30)保护作用不大,但瑞巴派特对NSAIDs导致的重度胃粘膜损伤(OR=0.19,95%CI:0.08~0.44)能产生明显的保护作用,差异具有统计学意义(P<0.05);在NSAIDs导致的小肠损伤方面,瑞巴派特能有效防治NSAIDs导致的中重度小肠粘膜损伤(糜烂(MD=-3.42,95%CI:-4.84^-2.00)、溃疡(MD=-0.47,95%CI:-0.92^-0.01)),差异具有统计学意义(P<0.05)。结论瑞巴派特不仅能改善NSAIDs导致的胃肠道症状,而且能有效防治NSAIDs导致的中重度全消化道粘膜损伤。 | 罗雪 高青 | 2019 | 世界最新医学信息文摘2019，0，43： | 1 |
| 7 | 阿司匹林相关性小肠粘膜损伤的研究进展显示文摘以阿司匹林为代表的非甾体抗炎药(NSAIDs)因具有良好的解热、镇痛、抗炎作用,目前已广泛应用于临床,由其导致的胃肠不良反应也备受关注。以往临床工作者主要关注胃十二指肠黏膜损伤,但对小肠黏膜损害的报道较少,随着小肠镜和胶囊内镜的发展,阿司匹林导致的小肠黏膜损伤越来越受到重视,现就阿司匹林致小肠粘膜损伤的诊疗进展作一综述。 | 罗雪 高青 | 2018 | 世界最新医学信息文摘2018，18，A5： | 1 |
| 8 | 抗血小板药物相关下消化道出血研究进展显示文摘抗血小板药物的使用与胃肠道出血显著相关,越来越多的证据表明使用抗血小板药物有下消化道出血(lower gastrointestinal bleeding,LGIB)的风险。本文对抗血小板药物相关LGIB的现状、发病机制、药物治疗、预后做一综述,拟为临床上抗血小板药物相关LGIB的诊治提供参考。 | 李灿灿 龙辉 | 2023 | 临床消化病杂志2023，35，5： | 0 |
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