非甾体类抗炎药与心血管疾病的研究进展

非甾体类抗炎药（NSAIDs）是当今广泛应用的一类药物。目前许多证据表明选择性的环氧化酶-2（COX-2）抑制剂具有不良心血管作用，包括增加心肌梗死、中风、心衰和高血压的危险，对有心血管病史或高心血管疾病危险者上述不良作用可能最为明显。对上述病人，仅在没有可替代的药物时使用COX-2抑制剂，并使用最小的剂量和必需的最短的时间。普通的非选择性的环氧化酶（COX）抑制剂其心血管安全性也有待更多的证据。因此，使用NSAIDs时要注意权衡利弊。

Advances in nonsteroidal antiinflammatory drugs and cardiovascular disease

Nonsteroidal antiinflammatory drugs （NSAIDs） are widely used nowadays, Current evidence indicates significant adverse cardiovascular effects induced by selective COX-2 inhibitors that include increased risk for myocardial infarction, stroke, heart failure, and hypertension. The risk for these adverse effects is likely highest in patients with a prior history of cardiovascular disease, or with high risk of cardiovascular disease. In these patients, use of COX-2 inhibitors for pain relief should be limited to patients for whom there are no appropriate alternatives, and then, only in the lowest dose and for the shortest duration necessary. More long-term data are needed to fully evaluate the extent to which these adverse cardiovascular effects may be offset by the benefits of these medications. More data are also needed on the cardiovascular safety of conventional NSAIDs. It is recommended that both patients and physicians should balance the risks and benefits of NSAIDs.