Arcimowicz Magdalena, Samoliński Bolesław, Gotlib Tomasz, Nyckowska Jagna
Katedra i Klinika Otolaryngologii AM w Warszawie.
Otolaryngol Pol. 2002;56(4):501-7.
Nonsteroidal antiinflammatory drugs (NSAIDs) are widely used in the treatment of controlling inflammatory process and relief of pain in upper airways disorders, due to their inhibition of the cyclooxygenase (COX). After classical NSAIDs different adverse effects are observed, which limit their usage in many patients. The beginning of the nineties gave the evidences, that two cyclooxygenase isoforms existed: COX-1 and COX-2. The blockage of COX-1 in consequence cause the adverse effects of NSAIDs. And COX-2 is responsible for the most inflammatory symptoms, such as pain, oedema, fever, increase of vessel permeability. So the selective inhibitors of COX-2 would be much more safe drugs, comparing with the classical NSAIDs in the treatment of inflammatory diseases. Nimesulide belongs to the new generation of NSAIDs. It not only inhibits more selectively the activity of COX-2, but has also some other properties, that increase its antiinflammatory and analgesic function. Effectiveness of nimesulide has been demonstrated by numerous clinical studies in various inflammatory diseases of upper airways. Its anti-inflammatory, analgesic and antipyretic efficacy has been at least comparable with classical NSAIDs, but the adverse effects of nimesulide have been milder and less frequent. So all those facts suggest, that nimesulide should be taken into account in the treatment of the inflammatory diseases of the ear, nose and throat.
非甾体抗炎药(NSAIDs)因其对环氧化酶(COX)的抑制作用,被广泛用于控制上呼吸道疾病的炎症过程和缓解疼痛。在使用传统NSAIDs后,会观察到不同的不良反应,这限制了它们在许多患者中的使用。20世纪90年代初有证据表明,存在两种环氧化酶同工型:COX-1和COX-2。抑制COX-1会导致NSAIDs出现不良反应。而COX-2则导致大多数炎症症状,如疼痛、水肿、发热、血管通透性增加。因此,与传统NSAIDs相比,COX-2选择性抑制剂在治疗炎症性疾病时可能更安全。尼美舒利属于新一代NSAIDs。它不仅能更有选择性地抑制COX-2的活性,还具有其他一些特性,可增强其抗炎和镇痛功能。众多临床研究已证实尼美舒利对上呼吸道各种炎症性疾病的有效性。其抗炎、镇痛和解热疗效至少与传统NSAIDs相当,但尼美舒利的不良反应更轻微且发生率更低。所以所有这些事实表明,在治疗耳鼻喉炎症性疾病时应考虑使用尼美舒利。