阿司匹林“过敏”的研究进展-内科学专业论文.docxVIP

重庆 重庆医科大学硕士研究生学位论文 万方数据 万方数据 英汉缩略语名词对照 英文缩写 英文全称 中文名称 NSAIDs Nonsteroidal anti-inflammatory drugs 非甾体抗炎药 COX Cyclooxygenase 环氧化酶 Cys-LT Cysteinyl Leukotriene 半胱氨酰白三烯 PGE2 Prostaglandin E2 前列腺素 E2 5-LO 5-Lipoxygenase 5-脂氧合酶 AERD Aspirin-exacerbated respiratory disease 阿司匹林加重呼吸疾病 CSU Chronic spontaneous urticaria 慢性自发性荨麻疹 AECD Aspirin-exacerbated cutaneous disease 阿司匹林加重皮肤病 EAACI European Academy Of Allergology And Clinical Immunology 欧洲过敏与临床免疫协会 FEV1 Forced expiratory volume in one second 1 秒用力呼气容积 SNPs Single Nucleotide Polymorphisms 单核苷酸多态性 UA Unstable Angina 不稳定性心绞痛 NSTEMI Non ST-segment Elevation Myocardial Infarction STEMI ST-segment Elevation Myocardial Infarction 非 ST 段抬高型心肌梗死 ST 段抬高型心肌梗死 PCI Percutaneous Coronary Intervention 经皮冠状动脉介入治疗 1 阿司匹林“过敏”的研究进展 摘 要 阿司匹林过敏是指患者使用阿司匹林后出现呼吸系统、皮肤甚至 全身性过敏反应，是造成阿司匹林不能耐受的原因之一。过敏机制被 认为有药理反应和免疫反应两大类，体内激发试验是诊断过敏的金标 准。对阿司匹林过敏者，脱敏治疗被认为是一种安全、有效的策略。 近年来已有多种脱敏方案应用于临床，尤其是对合并冠心病需要行冠 脉支架植入者。但目前缺乏一致标准的脱敏方案，脱敏治疗在临床应 用不足。本文就阿司匹林过敏的机制及临床分型、诊断及脱敏治疗的 研究进展作一综述。 关键词：阿司匹林，过敏反应，脱敏治疗，冠心病 2 PROGRESS IN ASPIRIN HYPERSENSITIVITY ABSTRACT Aspirin hypersensitivity involves respiratory, cutaneous or systemic reactions after aspirin administration, which may represent a major problem in patients with ischemic coronary disease, especially for patients who need a stenting procedure. Aspirin hypersensitivity including pharmacological and presumed immunologic reactions, depend on inhibition of the COX-1 pathway and specific IgE antibody against aspirin. The diagnosis of aspirin hypersensitivity is confirmed by provocation tests, while now there are no in vitro techniques have been recommended for routine diagnosis. Management of aspirin hypersensitivity varies in different types of reaction and different clinical centers. Desensitization is thought as a safe and effective way to deal with aspirin hypersensitivity, while precise mechanism remains unclear. Series of desensitization protocols have been successfully implied in clinic. However, as lacking of