James D S
Tulsa Regional Medical Center, OK, USA.
J Am Osteopath Assoc. 1999 Nov;99(11 Suppl):S1-7.
The clinical utility of nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation is limited by adverse side effects. Although effective analgesic and anti-inflammatory agents, NSAIDs are associated with side effects that are a consequence of nonspecific inhibition of both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). The primary adverse events associated with NSAID therapy are upper gastrointestinal (GI) ulceration, perforation, or bleeding, all of which involve mucosal damage of varying severity and can be asymptomatic and occur with little warning. Clinicians who prescribe NSAIDs should be able to identify patients who are at risk of an NSAID-induced GI adverse event and to detect and manage the event should one occur. The use of COX-2-specific inhibitors to manage pain and inflammation may minimize the risks of NSAID-associated toxicities.
非甾体抗炎药（NSAIDs）用于控制疼痛和炎症的临床效用受到不良反应的限制。尽管NSAIDs是有效的镇痛和抗炎药物，但它们会产生副作用，这是由于对环氧化酶-1（COX-1）和环氧化酶-2（COX-2）的非特异性抑制所致。与NSAID治疗相关的主要不良事件是上消化道（GI）溃疡、穿孔或出血，所有这些都涉及不同程度的黏膜损伤，且可能无症状且几乎没有预警就会发生。开具NSAIDs处方的临床医生应该能够识别有NSAID诱导的GI不良事件风险的患者，并在事件发生时进行检测和处理。使用COX-2特异性抑制剂来控制疼痛和炎症可能会将NSAID相关毒性的风险降至最低。
