从NSAIDs心血管不良反应机制探讨老年人用药管理  

Discussion on Medication Management in the Elderly from the Mechanism of Cardiovascular Adverse Reactions of NSAIDs

作　　者：罗桢敏[1] 杨科朋 陈劲柏[3] 傅利萍 刘潇 LUO Zhenmin;YANG Kepeng;CHEN Jinbai;FU Liping;LIU Xiao(Shaoxing Hospital of Traditional Chinese Medicine,Shaoxing 312000,Zhejiang,China;Department of Rheumatology,the Second Affi liated Hospital of Zhejiang University of traditional Chinese medicine,Hangzhou 310005,Zhejiang,China;Department of Western Medicine,Shaoxing Hospital of Traditional Chinese Medicine,Shaoxing 312000,Zhejiang,China)

机构地区：[1]绍兴市中医院风湿科,浙江绍兴312000 [2]浙江中医药大学附属第二医院风湿科,浙江杭州310005 [3]绍兴市中医院西药剂科,浙江绍兴312000

出　　处：《中国药物滥用防治杂志》2021年第5期707-710,740,共5页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：浙江省中医药科教基金项目(编号:2020ZB267);浙江省中医药科教重点研究项目(编号:2021ZZ015);浙江省卫计委立项(2015ZHB015)。

摘　　要：非甾体类抗炎药(non-steroid anti-infl ammatory drugs,NSAIDs)是环氧合酶(cyclooxygenase,COX)抑制剂,而COX是前列腺素合成的限速酶,也是非甾体类抗炎药的靶酶,其抗炎作用较强,对炎症性疼痛有较好的效果。但长期服用NSAIDs易引发胃肠道、心血管等不良反应,尤其在老年患者中,因其机体衰退,特异性COX-2抑制剂的心血管不良反应需要格外重视。临床应用应该结合老年患者的基础疾病、炎症状态、合并用药等情况进行仔细评估和分析药物的风险,加强用药管理。Non-steroidal anti-infl ammatory drugs(NSAIDs)are inhibitors of cyclooxygenase(COX),while COX is a ratelimiting enzyme for prostaglandin synthesis and a target enzyme for NSAIDs.It has strong anti-infl ammatory effect and good effect on infl ammatory pain.However,long-term use of NSAIDs can easily lead to adverse reactions such as gastrointestinal tract and cardiovascular diseases.Especially in elderly patients,due to their body recession,the cardiovascular adverse reactions of specifi c COX-2 inhibitors need special attention.The clinical application should carefully evaluate and analyze the risks of drugs in combination with the patients’basic diseases,infl ammatory status and combined medication,so as to strengthen the medication management.

关 键 词：环氧合酶 COX-1 COX-2 非甾体抗炎药 药物不良反应 

分 类 号：R954[医药卫生—药学]