Проблема НПВП-гастропатии: современные представления

Осложнения со стороны верхних отделов ЖКТ, связанные с использованием нестероидных противовоспалительных препаратов (НПВП) - серьезная социальная и медицинская проблема. Число лиц, нуждающихся в приеме НПВП и низких доз аспирина, неуклонно растет. Большинство из них представлено людьми пожилого возраста, имеющими серьезную коморбидную патологию, существенно повышающую риск развития лекарственных осложнений. Частота НПВП-гастропатии остается на высоком уровне даже после внедрения в практику селективных ингибиторов циклоокси-геназы-2 (ЦОГ) и очевидных успехов в лечении H. Pylori-ассоциированных пептических язв. ЖКТ-кровотечение и перфорация, возникающие на фоне приема НПВП, сопровождаются высокой смертностью и требуют серьезных затрат на лечение. Это определяет необходимость адекватной профилактики данной патологии. Основными методами профилактики НПВП-гастропатии является учет факторов риска, применение более безопасных препаратов этой группы и назначение противоязвенных средств, снижающих риск развития эрозивно-язвенных изменений и кровотечений. Новым препаратом для профилактики гастроинтестинальных осложнений на фоне приема НПВП и антитромботических средств является гастроэнтеропротектор ребамипид. Преимущество этого препарата связано со способностью предотвращать не только развитие эрозий и язв верхних отделов ЖКТ, но также тонкой и толстой кишки.

НПВП, НПВП-гастропатия, ЖКТ-кровотечение, профилактика, ИПП, ребамипид

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