水杨酸盐不耐受：病理生理学、临床谱、诊断和治疗。
Salicylate intolerance: pathophysiology, clinical spectrum, diagnosis and treatment.
机构信息
Medizinische Universitätsklinik 3 mit Poliklinik, Krankenhausstrasse 12, Erlangen, Germany
出版信息
Dtsch Arztebl Int. 2008 Feb;105(8):137-42. doi: 10.3238/arztebl.2008.0137. Epub 2008 Feb 22.
INTRODUCTION
Acetylic salicylic acid (aspirin) intolerance relates to altered generation and metabolism of arachidonic acid and eicosanoids, and prostaglandins and leukotrienes ingestion of salicylates or COX-inhibitors.
METHODS
Selective review of literature in PubMed and the Cochrane Library.
RESULTS
Rhinitis, asthma and nasal polyposis are typical presentations, but urticaria and gut inflammation are also described. The mechanism involves a specific reaction to COX inhibitor substances in analgesics, cosmetics or plants resulting in an abnormal pattern of eicosanoids (prostaglandins and leucotrienes). The diagnosis is based on symptoms occurring immediately following ingestion of these substances or on refractory polyp formation. Blood tests may be helpful in unclear cases. Avoidance of triggering agents is helpful. Corticosteroids are the mainstay of pharmacological treatment. Biological, desensitization treatment involving the administration of increasing amounts of acetylic salicylic acid may also be used.
DISCUSSION
Asthma, rhinitis and nasal polyps, as well as chronic gastrointestinal irritation and urticaria following acetylic salicylic acid ingestion may suggest intolerance.
简介
乙酰水杨酸（阿司匹林）不耐受与花生四烯酸和类二十烷酸以及前列腺素和白三烯的生成和代谢改变有关，摄入水杨酸盐或 COX 抑制剂。
方法
在 PubMed 和 Cochrane 图书馆中选择性地回顾文献。
结果
鼻炎、哮喘和鼻息肉是典型的表现，但荨麻疹和肠道炎症也有描述。其机制涉及对镇痛药、化妆品或植物中的 COX 抑制剂物质的特定反应，导致类二十烷酸（前列腺素和白三烯）的异常模式。诊断基于摄入这些物质后立即出现的症状或难治性息肉形成。在不明确的情况下，血液检查可能会有所帮助。避免触发因素是有帮助的。皮质类固醇是药物治疗的主要方法。也可以使用生物脱敏治疗，包括逐渐增加乙酰水杨酸的剂量。
讨论
哮喘、鼻炎和鼻息肉，以及摄入乙酰水杨酸后慢性胃肠道刺激和荨麻疹可能提示不耐受。
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