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起因性小腸病変のカプセル内視鏡による前向き評価

著者： 石原誠¹ 大宮直木¹ 中村正直¹ 竹中宏之¹ 森島賢治¹ 小原圭¹ 水谷太郎¹ 山村健史¹ 宮原良二² 渡辺修¹ 安藤貴文¹ 川嶋啓揮¹ 伊藤彰浩¹ 廣岡芳樹² 後藤秀実¹²

所属機関： ¹名古屋大学大学院消化器内科学 ²名古屋大学医学部附属病院光学医療診療部

ページ範囲：P.161 - P.165

要旨　カプセル内視鏡の登場によりNSAID起因性小腸病変の臨床像が明らかにされつつある．NSAIDは内服期間の長短にかかわらず高率に小腸粘膜病変を引き起こす．COX-2選択的阻害薬は短期的には小腸病変の発症を軽減するが，長期的には非選択的NSAIDと同等のリスクがあるという報告もあり，NSAID起因性小腸病変の予防・治療薬が望まれている．近年レバミピドやミソプロストールなどがNSAID起因性小腸病変に対して有用であると報告されているが，少数例でもあり今後さらなる症例検討が必要である．またカプセル内視鏡にて多数の小腸病変を認めるも臨床的に無症状例も多く，治療適応や長期予後など今後の検討課題は多い．

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