胃と腸45巻3号

2010年03月発行

今月の主題 出血性小腸疾患─内視鏡診断・治療の最前線 主題

出血性小腸疾患の診断―潰瘍性病変─NSAIDs腸炎を中心に

著者： 田中周¹ 藤森俊二¹ 山田祐希江¹ 高橋陽子¹ 江原彰仁¹ 小林剛¹ 瀬尾継彦¹ 三井啓吾¹ 辰口篤志¹ 坂本長逸¹

所属機関： ¹日本医科大学消化器内科

ページ範囲：P.371 - P.378

要旨　カプセル内視鏡によりNSAIDs起因性小腸粘膜傷害の実態が明らかになりつつある．アスピリンを含むNSAIDsの常用患者の70％以上に，また通常型NSAIDsの2週間の内服で60％近い服用者に小腸の粘膜傷害が認められた．選択的COX-2阻害薬は短期的には小腸粘膜傷害の発生を軽減させるが，長期的には通常型NSAIDsと粘膜傷害の頻度に差がないという報告もあり，NSAIDs起因性小腸粘膜傷害の治療・予防薬が望まれる．近年，本邦でミソプロストールやレバミピドを用いてNSAIDs起因性小腸粘膜傷害の抑制効果を調べた研究が行われ有望な結果が得られた．今後，他の薬剤を含め投与法，投与量などの検討が望まれる．

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