Renal effects of cyclooxygyenase-2-selective inhibitors
Renal effects of cyclooxygyenase-2-selective inhibitors
复制标题
DOI：
10.1016/s0885-3924(02)00370-6
复制
发表时间：
2002-04-01
影响因子：
4.7
通讯作者：
Brater, DC
中科院分区：
文献类型：
--
作者：
Brater, DC
非甾体抗炎药（NSAIDs）被广泛使用。这些药物与通过抑制环氧合酶（CO）减少肾胰高血糖素合成引起的不良肾脏效应相关。考克斯的两种同种型，考克斯-1和考克斯-2，在肾脏中以组成型和诱导型表达。因此，假设考克斯-2选择性抑制剂罗非昔布和塞来昔布对肾功能的影响与非选择性NSAID相似。一些研究已经评估了这个问题，尽管它们有不同的研究模型，有些研究存在设计缺陷，限制了它们的解释。因此，结论应基于观察到的效应模式，而不是单个数据。这些研究表明，塞来昔布和罗非昔布均可导致钠潴留，并降低肾小球滤过率（GFR），其程度与非选择性NSAID在有肾脏不良反应风险的患者中相似。因此，当给予选择性考克斯-2抑制剂时，应使用与非选择性NSAID相同的关于肾鱼的注意事项。(C)美国癌症疼痛缓解委员会，2002年。
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used. These agents are associated with adverse renal effects caused by the reduction in synthesis of renal prostaglandins through inhibition of cyclooxygenase (CO). Both isoforms of COX, COX-1 and COX-2, are expressed in the kidney in constitutive and inducible forms. It is assumed therefore that the COX-2-selective inhibitors, rofecoxib and celecoxib, would have an effect on renal function similar to that of nonselective,NSAIDs. Several studies have evaluated this issue, although they have different study models and some have design flaws that limit their interpretation. Therefore, conclusions should be based on the pattern of observed effects rather than on individual data. These studies suggest that both celecoxib and rofecoxib can cause sodium retention and decrease glomerular filtration rate (GFR) to a similar extent as nonselective NSAIDs in patients at risk for adverse renal effects. Consequently, the same precautions regarding renal fish that are followed for nonselective NSAIDs should be used when selective COX-2 inhibitors are administered. (C) U.S. Cancer Pain Relief Committee, 2002.