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【drug-news】血管扩张剂与严重消化道溃疡有关
NEW YORK (Reuters Health) Jan 03 - Four cases of oral and anal ulcerations associated with the use of the anti-anginal agent nicorandil are reported in the December issue of the European Journal of Gastroenterology and Hepatology.
Dr. Ayman S. Abdelrazeq of Earswick, York, United Kingdom, and colleagues describe the case of a 93-year-old woman presenting with anal pain and a purulent discharge 24 months after starting nicorandil for severe angina. The patient had a natal cleft and umbilical ulceration and a perianal abscess. The ulcerations worsen and the woman eventually underwent a loop sigmoid colostomy. However, symptoms continued to worsen.
An additional two patients with colostomies after surgery for colon cancer and one patient with an ileostomy for the treatment of ulcerative colitis had clinically similar symptoms and histologically similar parastomal ulcerations to the index case. These three patients had been started on nicorandil 6 to 60 months prior to symptom onset.
Nicorandil was discontinued and the patients were begun on alternative anti-anginal medication.
Pain reduction was "prompt" and ulcers healed spontaneously within 9 weeks of drug discontinuation in all cases without recurrence. There were no adverse cardiac events in any of the four patients.
The researchers note that nicorandil, a hybrid of nitrates and a potassium channel activator, "has recently been implicated in the pathogenesis of anal and oral ulceration."
As nicorandil use is increasing, this previously rare presentation may begin to occur more often, Dr. Abdelrazeq's group points out. The drug should be excluded as the cause of parastomal ulceration before other major interventions are considered. They also caution that alternative antianginal therapy should be coordinated with a cardiologist.
Eur J Gastroenterol Hepatol 2006;18:1293-1295.
http://www.medscape.com/viewarticle/550221 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Vasodilator Associated With Severe Gastrointestinal Ulceration
血管扩张剂与严重消化道溃疡有关
NEW YORK (Reuters Health) Jan 03 - Four cases of oral and anal ulcerations associated with the use of the anti-anginal agent nicorandil are reported in the December issue of the European Journal of Gastroenterology and Hepatology.
纽约（路透社健康资讯）1月3日——12月发表的《欧洲胃肠病学和肝脏病学杂志》报告了4例与应用抗心绞痛药物尼可地尔相关的口腔和肛门溃疡病例。
Dr. Ayman S. Abdelrazeq of Earswick, York, United Kingdom, and colleagues describe the case of a 93-year-old woman presenting with anal pain and a purulent discharge 24 months after starting nicorandil for severe angina. The patient had a natal cleft and umbilical ulceration and a perianal abscess. The ulcerations worsen and the woman eventually underwent a loop sigmoid colostomy. However, symptoms continued to worsen.
英国约克郡Earswick的Ayman S. Abdelrazeq博士和同事描述了1例93岁的女患，因重度心绞痛服用尼可地尔24个月后出现肛门疼痛和排脓性便。该患者患有臀沟和脐溃疡以及肛周脓肿。溃疡恶化，最终该女患经受了乙状结肠袢式造口术。然而，症状持续恶化。
An additional two patients with colostomies after surgery for colon cancer and one patient with an ileostomy for the treatment of ulcerative colitis had clinically similar symptoms and histologically similar parastomal ulcerations to the index case. These three patients had been started on nicorandil 6 to 60 months prior to symptom onset.
另外2例患者结肠癌性结肠造口术和1例患者因溃疡性结肠炎行回肠造口术治疗后出现了与首例相似的临床症状和组织学检查相似的造口旁溃疡。这3例患者于出现临床症状前6到60个月开始服用尼可地尔。
Nicorandil was discontinued and the patients were begun on alternative anti-anginal medication.
患者停用了尼可地尔，并开始接受替代的抗心绞痛药物疗法。
Pain reduction was "prompt" and ulcers healed spontaneously within 9 weeks of drug discontinuation in all cases without recurrence. There were no adverse cardiac events in any of the four patients.
所有患者停药后均疼痛迅速减轻，9周内溃疡自然愈合且无复发。4例患者均无严重心脏意外发生。
The researchers note that nicorandil, a hybrid of nitrates and a potassium channel activator, "has recently been implicated in the pathogenesis of anal and oral ulceration."
研究者指出，尼可地尔——一种硝酸盐和钾通道激活剂的混合物，“最近被发现与肛门和口腔溃疡的发病相关。”
As nicorandil use is increasing, this previously rare presentation may begin to occur more often, Dr. Abdelrazeq's group points out. The drug should be excluded as the cause of parastomal ulceration before other major interventions are considered. They also caution that alternative antianginal therapy should be coordinated with a cardiologist.
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作者:admin@医学,生命科学 2011-03-27 17:14
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