Knijff-Dutmer E A, Martens A, vd Laar M A
Department of Rheumatology, Medisch Spectrum Twente Enschede, The Netherlands.
Ann Rheum Dis. 1999 Apr;58(4):257-9. doi: 10.1136/ard.58.4.257.
To test the hypothesis that nabumetone (a partially selective cyclooxygenase-(COX)-2 inhibitor) has less effect on platelet aggregation than naproxen (a non-selective COX-inhibitor) in patients with rheumatoid arthritis (RA).
A crossover study in 10 RA patients was performed, using either nabumetone or naproxen for two weeks, and, after a washout period of two weeks, the other drug during another two weeks. Platelet aggregation studies were performed and bleeding time was assessed before and after each treatment period.
Maximum platelet aggregation induced by epinephrine and by collagen was significantly more reduced after the use of naproxen than of nabumetone; secondary aggregation induced by ADP and epinephrine disappeared more often by naproxen than by nabumetone. Bleeding times were not influenced.
COX dependent platelet aggregation in RA patients seems to be more inhibited by naproxen than by nabumetone. This may be relevant for patients requiring non-steroidal anti-inflammatory drug treatment but who have an increased risk of bleeding as well.
验证在类风湿关节炎（RA）患者中，萘丁美酮（一种部分选择性环氧化酶 -（COX）-2抑制剂）对血小板聚集的影响小于萘普生（一种非选择性COX抑制剂）这一假设。
对10例RA患者进行交叉研究，使用萘丁美酮或萘普生治疗两周，经过两周的洗脱期后，再使用另一种药物治疗两周。在每个治疗期前后进行血小板聚集研究并评估出血时间。
使用萘普生后，肾上腺素和胶原诱导的最大血小板聚集比使用萘丁美酮时显著降低更多；ADP和肾上腺素诱导的二次聚集在萘普生治疗时比萘丁美酮治疗时更常消失。出血时间未受影响。
RA患者中COX依赖性血小板聚集似乎受萘普生的抑制比萘丁美酮更强。这对于需要非甾体抗炎药治疗但出血风险增加的患者可能具有相关性。
