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[20110524. Issues on duodenal ulcer (6): PPI maintenance instead of H2RA]

¾îÁ¦ Á¦½ÃÇÑ ±×¸²À» ´Ù½Ã µé¿©´Ù º¾½Ã´Ù. Çѹø ÃâÇ÷ÇÑ ½ÊÀÌÁöÀå±Ë¾çÀº H2RA·Î maintenanceÇÏÁö ¾Ê´Â ÇÑ, 1³â¿¡ 5-6%¾¿ ²ÙÁØÈ÷ ÀçÃâÇ÷À» ÀÏÀ¸Åµ´Ï´Ù. ±×·¡¼­ 5³âÀÌ»ó »êºÐºñ¾ïÁ¦Á¦¸¦ ½á¾ß ÇÕ´Ï´Ù (¾ðÁ¦ ²÷¾îµµ µÇ´ÂÁö´Â ¾Ë ¼ö ¾ø½À´Ï´Ù). ¹°·Ð Ç︮ÄÚ¹ÚÅÍ Á¦±ÕÄ¡·á¸¦ ÇÏÁö ¾Ê¾Ò´Ù´Â ÀüÁ¦°¡ ÇÊ¿äÇÕ´Ï´Ù.

¸¸¾à H2RA ´ë½Å PPI¸¦ ¾²¸é ¾î¶°ÇÒ±î¿ä? ±Ù°Å´Â ºÎÁ·ÇÕ´Ï´Ù. Evidence-based medicine ½Ã´ëÀ̹ǷΠ¸»µµ ¾ÈµÇ´Â ¼Ò¸®·Î Ãë±ÞÇØ ¹ö¸±±î¿ä?

Àú´Â Ç︮ÄÚ¹ÚÅÍ Á¦±ÕÄ¡·á¸¦ ÇÒ ¼ö ¾ø´Â ½ÊÀÌÁöÀå±Ë¾ç ÃâÇ÷ ȯÀÚ¿¡¼­ À¯Áö¿ä¹ýÀ¸·Î H2RA ´ë½Å PPI¸¦ ¾¹´Ï´Ù. Half dose PPI¸¦ ÀÌƲ¿¡ Çѹø »ç¿ëÇÏ°í Àִµ¥ Àç¹ßµÈ ¿¹¸¦ º» ÀûÀÌ ¾ø½À´Ï´Ù.


[±Ë¾ç Àç¹ßÀ̳ª NSAIDs ±Ë¾çÀ¸·Î PPI Àå±â º¹¿ëÇϽô ºÐÀÌ PPI¸¦ ²÷¾úÀ» ¶§ÀÇ À§Ç輺]

¾Æ·¡ ȯÀÚ´Â ÀÚÀÇ·Î PPIÀ» ²÷´Â °ÍÀÌ ¾ó¸¶³ª À§ÇèÇÑÁö Àß º¸¿©ÁÝ´Ï´Ù. Attenuated FAP ¼ö¼ú ÈÄ ½ÊÀÌÁöÀå õ°øÀÌ ÀÖ¾î primary repair¸¦ Çϼ̴ø ºÐÀÔ´Ï´Ù (»ó¼¼ º´·ÂÀº ¾Ë ¼ö ¾øÀ½. Ÿº´¿ø ¼ö¼ú). ¸î ³â ÈÄ ½ÊÀÌÁöÀå±Ë¾ç ÃâÇ÷·Î ³»¿øÇÏ¿© ÀÔ¿øÄ¡·áÇÏ¿´°í esomeprazoleÀ» Åõ¿©ÇÏ¿´À¸¸ç Æò»ý µå½Ãµµ·Ï °­Á¶ÇÏ¿© ¼³¸íÇÏ¿´½À´Ï´Ù. ±×·±µ¥ ¸î °³¿ù ÈÄ CVA°¡ ¹ß»ýÇÏ¿© Àαٺ´¿ø¿¡ ÀÔ¿øÇÏ¿© Ä¡·á ÈÄ aspirin°ú silostazoleÀ» º¹¿ëÇϼ̴µ¥ esomeprazoleÀº ó¹æµÇÁö ¾Ê¾Ò°í, ȯÀÚµµ Áý¿¡ ³²¾ÆÀÖ´ø esomeprazoleÀ» µå½ÃÁö ¾Ê¾Ò½À´Ï´Ù. ±×¸®°í ¸çÄ¥ ÈÄ ½ÊÀÌÁöÀå±Ë¾ç ÃâÇ÷·Î ´Ù½Ã ÀÔ¿øÇϼ̽À´Ï´Ù. EsomeprazoleÀ» Åõ¿©ÇÏ¿´À¸¸ç "Æò»ý µå½Ãµµ·Ï" 10¹ø °­Á¶ÇÏ¿© ¼³¸íÇÏ¿´½À´Ï´Ù. °í·É ȯÀÚ¿¡°Ô ¿©·¯ ¹®Á¦°¡ ¹ß»ýÇÒ ¼ö Àִµ¥... ȯÀÚ°¡ esomeprazoleÀ» ²÷Áö ¾Ê°í Æò»ý µå½Ç ¼ö ÀÖÀ»Áö ÀÇ»ç·Î¼­ °ÆÁ¤ÀÌ ÅÂ»ê °°½À´Ï´Ù.

(2018. 71¼¼ ¿©¼º)

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