胃と腸46巻2号

2011年02月発行

今月の主題 NSAID起因性小腸病変 主題

NSAID起因性小腸病変

著者： 藤森俊二¹ 遠坂由紀子¹ 馬來康太郎¹ 豊田将大¹ 春日祐介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 米澤真興¹ 田中周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.128 - P.136

要旨　小腸内視鏡の進歩は，非ステロイド性抗炎症薬（NSAID）により，胃のみならず小腸に多彩な病変が高頻度に起こることを明らかにした．特に通常型NSAIDでは2週間で50％を超える服用者に小腸粘膜障害が現れる．NSAID起因性小腸粘膜傷害には粘膜障害と絨毛欠損という異なる2種類の形態があり，小腸粘膜傷害の起因には複数の因子が関与している．NSAID起因性胃粘膜傷害に対して予防法・治療法が確立したため，NSAID服用者の下部消化管傷害に対する対応の確立が急務となっている．本邦を中心として，NSAID起因性小腸粘膜傷害に対する予防薬・治療薬の候補を探すため二重盲検無作為化比較試験を含む複数の試験が小規模ながら行われた．今後は見込みのある薬に対して，より大規模な臨床試験が望まれる．

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