Role of non-steroidal anti-inflammatory drugs on intestinal permeability and nonalcoholic fatty liver disease

The use of non-steroidal anti-inflammatory drugs(NSAIDs) is widespread worldwide thanks to their analgesic, anti-inflammatory and antipyretic effects. However, even more attention is placed upon the recurrence of digestive system complications in the course of their use. Recent data suggests that the complications of the lower gastro-intestinal tract may be as frequent and severe as those of the upper tract. NSAIDs enteropathy is due to enterohepatic recycling of the drugs resulting in a prolonged and repeated exposure of the intestinal mucosa to the compound and its metabolites. Thus leading to so-called topical effects, which, in turn, lead to an impairment of the intestinal barrier. This process determines bacterial translocation and toxic substances of intestinal origin in the portal circulation, leading to an endotoxaemia. This condition could determine a liver inflammatory response and might promote the development of nonalcoholic steatohepatitis, mostly in patients with risk factors such as obesity, metabolic syndrome and a high fat diet, which may induce a small intestinal bacterial overgrowth and dysbiosis. This alteration of gut microbiota may contribute to nonalcoholic fatty liver disease and its related disorders in two ways: firstly causing a malfunction of the tight junctions that play a critical role in the increase of intestinal permeability, and then secondly leading to the development of insulin resistance, body weight gain, lipogenesis, fibrogenesis and hepatic oxidative stress.

雷贝拉唑治疗十二指肠球部溃疡的疗效观察

目的 观察雷贝拉唑治疗十二指肠球部溃疡的疗效。方法 十二指肠球部溃疡患者随机,开放式服用雷贝拉唑10 mg/d,2周,记录治疗前和用药期间的腹痛、腹胀、厌食、嗳气、反酸的变化情况。结果 十二指肠球部溃疡的治愈率92.50％,第7天上腹痛、腹胀、厌食、嗳气、反酸的缓解率分别为98.15％、93.33％、85.37％、88.00％、100.00％。结论 雷贝拉唑对十二指肠球部溃疡,能够很好控制症状,完全愈合溃疡。具有起效快、疗效稳定长久、药物相互作用小、副作用少等优点,是治疗消化性溃疡特别是十二指肠球部溃疡的一个理想的新一代质子泵抑制剂。