| 特集名 | 消化性潰瘍診療ガイドラインを臨床にどのように生かすか |
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| 題名 | 低用量アスピリン潰瘍の予防と治療 |
| 発刊年月 | 2010年 12月 |
| 【 要旨 】 | 高齢化社会の到来は，アテローム血栓症に関連する疾患の増加をもたらすとともに，抗血小板療法である，低用量アスピリンの使用が急増している．アスピリンは，他の非ステロイド性抗炎症薬(NSAIDs)と同様，COX阻害を介し，消化管粘膜傷害をもたらす．アスピリンを必要とする心血管系患者は，高齢であり，抗炎症作用を目的としたNSAIDsの併用や，血栓リスクの高い場合は抗血小板薬の2剤併用頻度が高いことから，消化性潰瘍および潰瘍合併症(出血，穿孔)のリスクが高い．アスピリン使用者における潰瘍合併症は入院を要するだけではなく，重篤化する可能性があるため，アスピリンによる潰瘍リスクを考慮した，予防・治療の確立が望まれる． |
| Theme | Review of New Japanese Guideline for Peptic Ulcer Treatment |
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| Title | Prophylactic and Active Treatment of Gastric Ulcers with Low-dose Aspirin for Elderly Patients |
| [ Summary ] | Low-dose aspirin, one non-steroidal anti-inflammatory drug (NSAID), is increasingly used to prevent cardiovascular and cerebrovascular disease because of its anti-platelet effects, especially in the elderly population. However, aspirin based treatment is associated with gastrointestinal injuries, especially bleeding peptic ulcers. However, since discontinuation of aspirin, may precipitate cardiovascular and cerebrovascular events treatment of aspirin-associated ulcers should continue in order to restart aspirin therapy as soon as possible, often using proton pump inhibitors (PPIs). High-risk patients, such as those with a history of bleeding peptic ulcers should be treated with antisecretory drugs, such as PPIs or histamine H2 receptor antagonists. However, there is a reduced risk associated with PPI treatment because patients with bleeding ulcers may resume low-dose aspirin treatment. |