非甾体类抗炎药对冠心病的影Ⅱ向

目的指导临床医生和患者合理使用非甾体类抗炎药，尽量避免冠心病的发生与发展。方法对近年来关于非甾体类抗炎药与冠心病的一些回顾性研究进行分析、归纳、总结。结果非选择性非甾体类抗炎药如双氯酚酯、布洛芬有增加心血管事件的危险；相反，阿司匹林、萘普生及美罗昔康使心绞痛复发率，心肌梗死和死亡的发生率，需要冠状动脉血管重建的百分率均明显减少。而特异性COX-2抑制剂具有液体潴留、恶化高血压、增加心血管事件的发生与发展。结论非甾体类抗炎药尤其是特异性COX-2抑制剂具有促进冠心病的发生与发展，但仍需临床研究进一步证实。

Impact of Nonsteroidal Anti-Inflammatory Drugs on Coronary Heart Disease

Objective To guide elinicians and patients to reasonablely use non-steroidal anti-inflammatory drugs, and to avoid the occurrence and development of coronary heart disease. Methods Retrospective study of non-steroidal anti-inflammatory drugs and some of coronary heart disease were analyzed and summarized. Results Non-selective non-steroidal anti-inflammatory drugs such as diclofenac ester,ibuprofen increased the risk of cardiovascular events;On the contrary, aspirin, naproxen, and piroxicam might significantly reduce the recurrence rate of angina and the occurrence rate of myocardial infarction. The specific COX-2 in- hibitors induced fluid retention, deterioration of high blood pressure, and increased the occurrence rate of cardiovascular events. Conclusion Non-steroidal anti-inflammatory drugs, especially the specific COX-2 inhibitors, might promote the occurrence and development of coronary heart disease, but it still need more clinical study to be confirmed.