rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2009-5-4-65-72rpcardio-689Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИGASTROENTEROPATHIES ASSOCIATED WITH ACETYLSALICYLIC ACID: HOW TO IMPROVE SAFETY OF THERAPYГАСТРОЭНТЕРОПАТИИ, СВЯЗАННЫЕ С ПРИЕМОМ АЦЕТИЛСАЛИЦИЛОВОЙ КИСЛОТЫ: КАК ПОВЫСИТЬ БЕЗОПАСНОСТЬ ЛЕЧЕНИЯКомаровА. Л.KomarovA. L.

121552 Москва, 3-я Черепковская ул., 15а

Tretya Cherepkovskaya ul. 15a, Moscow, 121552

andrkomarov@mail.ruИнститут клинической кардиологии им. А.Л. Мясникова Российского кардиологического научно-производственного комплексаРоссияInstitute of Clinical Cardiology named after A.L. Myasnikov, Russian Cardiology Research and Production ComplexRussian Federation200910012016546572Copyright © Komarov A.L., 20162016Комаров А.Л.Komarov A.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/689

Lesion of gastrointestinal mucous coat is the main factor limited acetylsalicylic acid (ASA) use in patients with atherothrombosis. Up to date the mostly comprehensible way to decrease gastrointestinal complications is taking ASA in the lowest effective dose, which is not higher than 75-81 mg daily. It is necessary if possible to avoid ASK usage in combination with other antiaggregants, anticoagulants, non-steroid and steroid anti-inflammatory drugs. Routine antiulcer therapy is not indicated for patients treated with ASA because there is a lack of clinical research data about efficacy of this approach. In high risk of dangerous gastrointestinal complications H. pylori eradication is recommended in combination with long term preventive therapy with gastric secretion inhibitors. Proton pump inhibitors are more preferred.

Повреждение слизистой оболочки желудочно-кишечного тракта является основным фактором, ограничивающим использование ацетилсалициловой кислоты (АСК) у больных атеротромбозом. На сегодняшний день самым доступным способом, позволяющим снизить риск желудочно-кишечных осложнений, остается прием АСК в минимально эффективной дозе, не превышающей 75-81 мг/сут. По возможности следует избегать сочетанного применения АСК с другими антиагрегантами, антикоагулянтами, нестероидными противовоспалительными препаратами и кортикостероидами. Рутинное назначение противоязвенной терапии у больных, получающих АСК, не показано в связи с недостатком клинических исследований, подтверждающих эффективность такой тактики. При наличии высокого риска серьезных осложнений рекомендуется эрадикация H. pylori в сочетании с длительной профилактической терапией ингибиторами желудочной секреции, среди которых отдавать предпочтение следует ингибиторам протонной помпы. 

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The authors declare that there are no conflicts of interest present.