Aspirin Therapy in Cardiovascular Disease with Glucose-6-Phosphate Dehydrogenase Deficiency, Safe or Not?
Aspirin Therapy in Cardiovascular Disease with Glucose-6-Phosphate Dehydrogenase Deficiency, Safe or Not?
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DOI：
10.1007/s40256-020-00460-8
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发表时间：
2020-12
影响因子：
3
通讯作者：
Jianle Li;Yicong Chen;Zilin Ou;Fubing Ouyang;Jiahui Liang;Zimu Jiang;Chun-Sen Chen;Pingping Li;Jiaxin Chen;Jiating Wei;J. Zeng
中科院分区：
文献类型：
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作者：
Jianle Li;Yicong Chen;Zilin Ou;Fubing Ouyang;Jiahui Liang;Zimu Jiang;Chun-Sen Chen;Pingping Li;Jiaxin Chen;Jiating Wei;J. Zeng
葡萄糖-6-磷酸脱氢酶（G6 PD）缺乏症是人类最常见的酶缺陷，可表现为急性溶血、新生儿黄疸或慢性溶血。摄入蚕豆，以及感染和某些药物，是G6 PD缺乏症患者急性溶血的最典型原因。阿司匹林是目前预防心血管疾病（CVD）治疗的基石，偶尔有报道称其会诱导G6 PD缺陷个体发生急性溶血。G6 PD缺陷通常无症状，许多患有这种酶缺陷的心血管疾病患者在没有G6 PD活性检查的情况下开始长期服用阿司匹林治疗;然而，尚未就阿司匹林在该人群中的安全性达成共识。一些研究报告了这个问题，并产生了相互矛盾的结果。在这篇综述中，我们讨论了阿司匹林诱导溶血的可能机制，并总结了临床证据阿司匹林的安全性与G6 PD缺乏症的主题。
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect, which may present as acute hemolysis, neonatal jaundice, or chronic hemolysis. Ingestion of fava beans, as well as infection and certain drugs, are the most typical causes of acute hemolysis in people with G6PD deficiency. Aspirin, the cornerstone in current therapies for the prevention of cardiovascular disease (CVD), is occasionally reported to induce acute hemolysis in G6PD-deficient individuals. G6PD deficiency is typically asymptomatic and many CVD patients with this enzyme defect start to take long-term aspirin therapy without G6PD activity examination; however, no consensus on the safety of aspirin in this population has been reached. A few studies have reported on this issue and produced contradictory results. In this review, we discuss the possible mechanisms of aspirin-induced hemolysis, and summarize clinical evidence regarding the safety of aspirin in subjects with G6PD deficiency.