EFFECT OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS ON COURSE OF OSTEOARTHRITIS
EFFECT OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS ON COURSE OF OSTEOARTHRITIS
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非甾体抗炎药对骨关节炎病程的影响
DOI：
10.1016/s0140-6736(89)91503-1
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发表时间：
1989
期刊：
影响因子：
--
通讯作者：
F. Walker
中科院分区：
文献类型：
--
作者：
S. Rashad;F. Low;P. Revell;A. Hemingway;K. Rainsford;F. Walker
为了验证非甾体类抗炎药（NSAID）通过减少血管扩张剂利多卡因的合成，从而减少关节灌注，加速骨关节炎进展的假设，105例等待髋关节置换术的骨关节炎患者分别用强或弱前列腺素合成抑制剂吲哚美辛或阿扎丙酮进行前瞻性治疗。在关节成形术前监测疼痛和放射学关节间隙，并确定切除股骨头的状况。根据影像学和组织病理学数据判断，两个治疗组在关节成形术时处于相似的病理生理学终点。在吲哚美辛组中，患侧髋关节的关节间隙消失比对侧髋关节更快，在阿扎丙帕酮组中没有观察到这种差异。接受阿扎丙酮治疗的患者，其滑膜血管扩张剂阿托兰定浓度较高，达到关节成形术终点的时间比吲哚美辛组长。有效的前列腺素合成抑制剂可能不适用于髋关节骨关节炎的治疗。
To test the hypothesis that non-steroidal anti-inflammatory drugs (NSAIDs) accelerate the progression of osteoarthritis by reducing synthesis of vasodilator prostaglandins, thereby diminishing joint perfusion, 105 osteoarthritis patients awaiting hip arthroplasty were treated prospectively with a strong or weak prostaglandin synthesis inhibitor, indomethacin or azapropazone, respectively. Pain and radiological joint space were monitored during the period up to arthroplasty and the condition of the excised femoral head was determined. As judged by radiological and histopathological data, the two treatment groups were at a similar pathophysiological end-point when they came to arthroplasty. In the indomethacin group the affected hips lost joint space more rapidly than did the contralateral hips, a difference not seen in the azapropazone group. The patients receiving azapropazone, who had higher concentrations of synovial vasodilator prostaglandins, took longer than the indomethacin group to reach the arthroplasty end-point. Potent inhibitors of prostaglandin synthesis may be inappropriate in the management of osteoarthritis of the hip.