摘要
非甾体抗炎药(Non-steroidal anti-inflammatory drug,NSAID)是常见的解热镇痛抗炎药。对没有肾脏基础疾病的年轻患者和无合并症的患者无很大危害。但因其存在剂量依赖性效应,故长期使用NSAID时应格外小心。长期、大量使用NSAID会增加肾脏损伤的风险,引起急性肾损伤(acute kidney injury,AKI)、慢性肾脏病(chronic kidney disease,CKD)、水电解质失衡、急性间质性肾炎(acute interstitial nephritis,AIN)及急性肾乳头坏死等。NSAID引起肾损伤机制复杂,对于高龄、既往有肾脏基础疾病等高危人群需警惕NSAID的肾损伤风险。因此,对这类药物的适应证和应用风险应进行谨慎评估,权衡利弊后再决定是否使用,应用中注意加强观察和监测,及时发现可能存在的不良反应并进行用药调整。
Non-steroidal anti-inflammatory drug(NSAID)are commonly used antipyretic,analgesic and anti-inflammatory drugs.Basically,there is no great harms to young patients without basic renal diseases and patients without complications.However,due to its dose-dependent effect,adverse reactions of NSAID should be monitored continuously when using NSAID for a long time.Long term and extensive use of NSAIDs could inevitably increase the risk of renal injury,causing acute kidney injury(AKI),chronic kidney disease(CKD),water electrolyte imbalance,acute interstitial nephritis(AIN)and acute renal papillary necrosis.The mechanism of renal injury caused by NSAID is complex.For high-risk groups such as the elderly and previous renal basic diseases,we should be alert to the risks of renal injury caused by NSAID.Therefore,the indications and application risks of such drugs should be well evaluated,and the decision on whether to use them should be made after balancing the advantages and disadvantages.Special attention should be paid to strengthening observation and monitoring the possible adverse reactions.
作者
陈玉强
汪年松
CHEN Yuqiang;WANG Niansong(Department of Nephrology,Shanghai Jiao Tong University Affiliated Sixth People's Hospital,Shanghai 200233,China)
出处
《世界临床药物》
2021年第10期829-832,共4页
World Clinical Drug
基金
上海市卫计委课题(2019SY018)。
关键词
非甾体抗炎药
急性肾损伤
慢性肾脏病
急性间质性肾炎
急性肾乳头坏死
nonsteroidal anti-inflammatory drug
acute renal injury
chronic kidney disease
acute interstitial nephritis
acute renal papillary necrosis
