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N Engl J Med:阿司匹林可加重呼吸道疾病?!

2018-10-12 吴星 环球医学

鼻息肉和鼻窦摘除术后,阿司匹林脱敏之后进行阿司匹林治疗(剂量为325~650mg每天两次)是AERD的标准治疗方法。

水杨酸已经有上千年的使用历史,可缓解发烧和疼痛。直到1922年,Widal才在病例报告中首次描述阿司匹林可加重呼吸道疾病。1967年后,阿司匹林加重呼吸道疾病(AERD)在美国成为了专业术语,反应疾病仅发生在下呼吸道。虽然AERD在美国和其他国家是专业术语,但许多欧洲和中东国家却偏好使用非甾体类抗炎药(NSAID)加重呼吸道疾病这个词。

AERD在出生时从不表现,在家族中也罕见聚集发生,它仅在女性中比在男性中稍微更常见,除了中国(发生率罕见),所有国家都可见。AERD的特征为鼻窦和鼻腔黏膜肿胀、息肉形成和哮喘。与其他疾病患者具有相同特征不同,AERD患者在摄入阿司匹林和其他NSAID后也会出现呼吸道反应。这些反应一般涉及上呼吸道和下呼吸道,也会发生皮肤症状(常伴随一定程度的呼吸道受累)。AERD的严重程度和进展具有显着差异。一方面,AERD仅累及上呼吸道,另一方面,AERD可造成严重哮喘和鼻窦炎。在患有哮喘或慢性鼻窦炎的患者中,合并AERD是最棘手的。

鼻息肉和鼻窦摘除术后,阿司匹林脱敏之后进行阿司匹林治疗(剂量为325~650mg每天两次)是AERD的标准治疗方法。

原始出处:

White AA, et al. Aspirin-Exacerbated Respiratory Disease. N Engl J Med. 2018 Sep 13;379(11):1060-1070. doi: 10.1056/NEJMra1712125.

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    2018-10-27 spoonycyy
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    2019-07-18 haouestc
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    2018-10-14 zhmscau
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    2018-10-12 liumin1987

    阿司匹林的副作用。

    0

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