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甾体抗炎药(NSAIDs)因具有解热、镇痛、抗炎、抗风湿、抗凝等作用,临床上已广泛用于各种骨关节炎、类风湿性关节炎和多种免疫功能紊乱的炎性疾病,以及各种疼痛症状的缓解等的治疗。随着NSAIDs使用量的增加,其不良反应也呈增多的趋势,美国每年因NSAIDs引起的胃肠道不良反应就导致10万患者住院,16500例患者死亡,费用已超过20亿美元【1】。另有报道【2】,在治疗风湿性关节炎或骨关节炎的医源性费用中,约有30%用于治疗胃肠道不良反应;而国内报道NSAIDs诱发的上消化道出血占总上消化道出血患者的16.5%～25.2%【3】。因此,合理使用NSAIDs是十分必要的。本文主要介绍几种常用非甾体抗炎药物的临床应用、不良反应及预防措施,以便临床更合理更安全地使用该类药物。
Steroidal anti-inflammatory drugs (NSAIDs) have been widely used clinically for various types of osteoarthritis, rheumatoid arthritis and various immune disorders due to antipyretic, analgesic, anti-inflammatory, anti-rheumatic and anticoagulant effects Inflammatory diseases, as well as a variety of pain relief and other treatment. With the increase in the use of NSAIDs, the adverse reactions also showed an increasing trend. The annual gastrointestinal adverse reactions caused by NSAIDs in the United States led to the hospitalization of 100,000 patients and the deaths of 16,500 patients at a cost of more than 2 billion U.S. dollars. [1] It is also reported [2], in the treatment of rheumatoid arthritis or osteoarthritis iatrogenic costs, about 30% for the treatment of gastrointestinal adverse reactions; and domestic reports of NSAIDs induced upper gastrointestinal bleeding accounted for the total Patients with gastrointestinal bleeding 16.5% ~ 25.2% [3]. Therefore, the rational use of NSAIDs is very necessary. This article describes the clinical application of several commonly used non-steroidal anti-inflammatory drugs, adverse reactions and preventive measures so that the clinical more reasonable and safer use of such drugs.