非甾体类抗炎药在心血管疾病患者中的合理使用

蔡宏文, 徐慧敏*

中国药学杂志 ›› 2014, Vol. 49 ›› Issue (6) : 512-516.

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中国药学杂志 ›› 2014, Vol. 49 ›› Issue (6) : 512-516. DOI: 10.11669/cpj.2014.06.020
药物与临床

非甾体类抗炎药在心血管疾病患者中的合理使用

  • 蔡宏文1, 徐慧敏2*
作者信息 +

Use of Nonsteroidal Antiinflammatory Drugs in Patients with Cardiovascular Disease

  • CAI Hong-wen1, XU Hui-min2*
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文章历史 +

摘要

目的 为非甾体类抗炎药(nonsteroidal anti-inflammatory drugs, NSAIDs)在心血管疾病患者中的合理应用提供用药指导。方法 阐述非甾体类抗炎药引起心血管风险的机制, 综述国内外关于不同非甾体类抗炎药心血管风险比较的临床研究和荟萃分析结果。结果 所有的非甾体类抗炎药均有可能增加心血管不良反应。不同非甾体类抗炎药的心血管风险与环氧酶-2选择性、是否干扰小剂量阿司匹林的抗血小板作用等有关。结论 临床上在心血管疾病患者中使用非甾体类抗炎药时, 应充分评估其治疗获益和心血管风险, 严格掌握其适应证和禁忌证, 合理选择不同种类的非甾体类抗炎药, 注意与阿司匹林的药物相互作用, 加强用药监测, 避免不良事件发生。

Abstract

OBJECTIVE To provide appropriate guidelines to optimize the rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) for patients with established cardiovascular disease (CVD). METHODS Mechanisms of increased CVD risk due to NSAIDs were elaborated. RESULTS of clinical researches and Meta-analysis for different NSAIDs in CVD risk were reviewed. RESULTS All NSAIDs are associated with an increased risk of cardiovascular adverse effects. The degree of selectivity for cyclooxygenase-2 and the interaction with low-dose aspirin may contribute to the CVD risk of different NSAIDs.CONCLUSION Physicians should weigh the benefits against risks for individual patients with CVD. NSAIDs should be used in strict accordance with indications and contraindications. Appropriate class of NSAIDs should be selected and interaction with aspirin should be avoided in patients with CVD. After the prescription of NSAIDs, the patients should be monitored to minimize the adverse effects.

关键词

非甾体类抗炎药 / 心血管疾病 / 环氧酶 / 心血管风险 / 合理用药

Key words

nonsteroidal anti-inflammatory drug / cardiovascular disease / cyclooxygenase / cardiovascular risk / drug rational use

引用本文

导出引用
蔡宏文, 徐慧敏*. 非甾体类抗炎药在心血管疾病患者中的合理使用[J]. 中国药学杂志, 2014, 49(6): 512-516 https://doi.org/10.11669/cpj.2014.06.020
CAI Hong-wen, XU Hui-min*. Use of Nonsteroidal Antiinflammatory Drugs in Patients with Cardiovascular Disease[J]. Chinese Pharmaceutical Journal, 2014, 49(6): 512-516 https://doi.org/10.11669/cpj.2014.06.020
中图分类号: R95   

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基金

浙江省医药卫生研究项目(2013KYB186);浙江省药学会医院药学科研专项基金项目(2011ZYY01)
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