Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya3213510.17116/terarkh20168812133-139Editorial articleПередовая статьяReview ArticleSmall bowel injuries due to nonsteroidal anti-inflammatory drugs and antiplatelet therapy. Approaches to prevention and treatmentПоражения тонкой кишки при применении нестероидных противовоспалительных препаратов и антитромбоцитарной терапии. Подходы к профилактике и лечениюDrapkinaO MДрапкинаО МKorneevaO NКорнееваО НГосударственный научно-исследовательский центр профилактической медицины Минздрава России151220168812VOL 88, NO12 (2016)ТОМ 88, №12 (2016)13313910042020Copyright ©; 2016, Consilium MedicumCopyright ©; 2016, ООО "Консилиум Медикум"2016Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/32135

Nonsteroidal anti-inflammatory drug (NSAID)-induced small bowel injuries (NSAID enteropathies) become clinically important. Videocapsule endoscopy shows that the small bowel is involved in NSAID-related gastrointestinal tract (GIT) injury in almost two-thirds of all cases. Due to a large number of patients who receive NSAIDs, combined antiplatelet therapy, or long use anticoagulants, GIT injury prevention becomes an actual problem. Treatment for NSAID enteropathy is different from that for NSAID gastropathy. In NSAID enteropathy, it is advisable to use drugs that are able to increase the production of prostaglandins and mucus, to restore intestinal epithelial permeability, and to exert anti-inflammatory and antioxidant effects. Rebamipide that produces many pleiotropic effects and also has cytoprotective properties may become the drug of choice for treating patients with NSAID enteropathy. In addition, rebamipide has no effects on various cytochrome P-450 enzyme systems, by reducing the risk of drug interactions.

Аннотация Поражения тонкой кишки, индуцированные нестероидными противовоспалительными препаратами (НПВП-энтеропатии), становятся клинически важными. По результатам видеокапсульной эндоскопии, почти 2/3 всех случаев ассоциированного с НПВП поражения желудочно-кишечного тракта (ЖКТ) приходится на тонкую кишку. Ввиду большого числа пациентов, принимающих НПВП, получающих комбинированную антитромбоцитарную терапию, длительно принимающих антикоагулянты, становится актуальной проблема профилактики поражений ЖКТ. При НПВП гастро- и энтеропатиях целесообразно использовать препараты, способные повышать продукцию простагландинов и слизи, восстанавливать проницаемость кишечного эпителия, оказывать противовоспалительные и антиоксидантные эффекты. Приоритетным препаратом, применяемым для лечения больных НПВП-энтеропатией, может стать ребамипид, который дает многие плейотропные эффекты, а также обладает цитопротективными свойствами. Кроме того, ребамипид не влияет на различные ферментные системы цитохрома Р-450, снижая риск взаимодействия лекарственных препаратов.

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