非甾体抗炎药物在骨性关节炎中应用.docVIP

非甾体抗炎药物在骨性关节炎中应用摘 要 骨性关节炎是老年人中常见、多发的慢性进行性骨关节疾病，主要临床表现为缓慢发展的可使活动受限的关节疼痛、僵硬和肿胀,严重的能导致关节功能障碍。非甾体抗炎药物是目前治疗骨性关节炎等关节炎性疾病的最常用药物，作用机制为抑制环氧化酶活性、阻断该酶催化花生四烯酸转化为炎性物质前列腺素，从而发挥止痛、消炎作用。非甾体抗炎药物分为非选择性环氧化酶抑制剂和选择性环氧化酶-2抑制剂两类，应用广泛，但也存在多种不良反应，故选择用药时要严格掌握适应证，合理用药。 关键词 非甾体抗炎药物 骨性关节炎 环氧化酶 中图分类号：R971.1 文献标识码：A 文章编号：1006-1533(2012)15-0005-04 The use of non-steroidal anti-inflammatory drugs in osteoarthritis DONG Yu, LI Yun-xia, CHEN Shi-yi （Sports Medicine Center, Department of Sports Medicine and Arthroscopy Surgery of Huashan Hospital, Fudan University, Shanghai 200040, China） Abstract Osteoarthritis (OA) is a kind of common and chronic progressing arthritis disease for the elderly. Its main clinical manifestation is progressing chronic arthralgia, rigidity, tumid accompanied with movement restriction, which lead to dysfunction of the knee joint if the condition is serious. Non-steroidal anti-inflammatory drugs (NSAID) is one of the most applied drugs for osteoarthritis and other arthritis diseases, whose mechanism is to inhibit cyclooxygenase activity and block this enzyme to catalyze arachidonic acid to prostaglandin so as to inhibit the inflammatory substance prostaglandin and play the analgesic and anti-inflammatory functions. NSAID is classified into two categories: non-selective cyclooxygenase inhibitor and selective cyclooxygenase-2 inhibitor, which are widely applied, but have a variety of adverse reactions. When choosing a drug for OA, we must strictly control its indications and rationally use it. Key Words non-steroidal anti-inflammatory drugs; osteoarthritis; cyclooxygenase 骨性关节炎（osteoarthritis, OA）又称退行性关节炎、退行性骨关节病等，是一种以关节软骨生化代谢异常、进行性变性和消失以及关节边缘和软骨下骨质产生反应性变化、使得软骨组织产生变化和关节囊纤维增生、最终导致关节疼痛和功能丧失为病理特点的临床综合征。OA可发生于各个关节，以在老年人中最为常见，男、女均可发病。随着我国社会人口老龄化进程的加快，OA的发病率正逐年增高。因此，如何有效地延缓OA进展、改善患者的临床症状并提高他们的生活质量也越来越受到人们的重视。在临床实践中，非甾体抗炎药物（non-steroidal anti-inflammatory drugs, NSAID）常用于OA的治疗。 1 OA的病因及病理表现 OA的病因目前尚未完全明了，多认为与年龄、损伤、过度负重、肥胖、遗传、环境和生物力学的改变等有关。按美国风湿病协会分类，OA分为原发性和继发性