阿司匹林的臨床應用進展_《華西醫學》

作者：

李才正 ,  苗佳

四川大學華西醫院國家藥物臨床試驗機構·GCP中心（成都，610041）;

關鍵詞：

阿司匹林臨床應用進展

視頻：

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阿司匹林是臨床處方量最大的常用藥物，其治療作用隨劑量不同而不同，具有良好的解熱、鎮痛、抗炎以及血小板聚集抑制作用等。隨著對該藥研究的深入，近年來又發現了阿司匹林的一些新應用，包括癌癥預防、糖尿病防治、緩解白內障等，但這些新應用尚需臨床進一步研究才能得以推廣。現主要針對阿司匹林的臨床應用進展進行綜述。

引用本文： 李才正,苗佳. 阿司匹林的臨床應用進展. 華西醫學, 2012, 27(7): 988-991. doi: 復制

1.	楊寶峰. 藥理學[M]. 7版. 北京: 人民衛生出版社, 2008: 179-185.
2.	Bitko V, Velazquez A, Yang L, et al. Transcriptional induction of multiple cytokines by human respiratory syncytial virus requires activation of NF-kappa B and is inhibited by Sodium salicylate and aspirin[J]. Virology, 1997, 232(2): 369-378.
3.	郭振輝, 洪新, 毛寶齡, 等. 阿司匹林新的抗炎機制研究[J]. 中國危重病急救醫學, 2000, 12(10): 602-605.
4.	Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients[J]. BMJ, 2002, 324(7329): 71-86.
5.	Kim KM, Song JJ, An JY, et al. Pretreatment of acetylsalicylic acid promotes tumor necrosis factor-related apoptosis-inducing ligand-induced apoptosis by down-regulating BCL-2 gene expression[J]. J Biol Chem, 2005, 280(49): 41047-41056.
6.	王振華. 淺析阿司匹林的臨床應用[J]. 基層醫學論壇, 2009, 13(14): 456-457.
7.	胡健, 李夢. 阿司匹林在缺血性心臟病中的臨床應用與評價[J]. 藥品評價, 2009, 6(7): 270-272.
8.	Collaborative Group of the Primary Prevention Project (PPP). Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomised trial in general practice[J]. Lancet, 2001, 357(9250): 89-95.
9.	中華醫學會心血管病學分會, 中華心血管病雜志編輯委員會. 阿司匹林在動脈硬化性心血管病中的臨床應用: 中國專家共識(2005)[J]. 中華心血管病雜, 2006, 34(3): 281-284.
10.	Bates ER, Lau WC. Controversies in antiplatelet therapy for patients with cardiovascular disease[J]. Circulation, 2005, 111(17): e267-e271.
11.	Ridker PM, Cook NR, Lee IM, et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women[J]. N Engl J Med, 2005, 352(13): 1293-1304.
12.	Steering Committee of the Physicians’ Health Study Research Group. Final report on the aspirin component of the ongoing Physicians’ Health Study[J]. N Engl J Med, 1989, 321(3): 129-135.
13.	Peto R, Gray R, Collins R, et al. Randomised trial of prophylactic daily aspirin in British male doctors[J]. Br Med J, 1988, 296(6618): 313-316.
14.	Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. HOT Study Group[J]. Lancet, 1998, 351(9118): 1755-1762.
15.	王蓓, 秦英, 梅祖敏. 阿司匹林抗癌機制的研究進展[J]. 河北醫科大學學報, 2007, 28(4): 315-318.
16.	李小安, 房殿春, 司佩任, 等. 腫瘤壞死因子相關配體與阿司匹林合用對肝癌SMMC-7721細胞凋亡的影響[J]. 中華肝臟病雜志, 2003, 11(11): 38-41.
17.	夏琳, 丁紅, 劉芳, 等. 阿司匹林對膠質瘤細胞生長增殖及NOS表達的影響[J]. 中國免疫學雜志, 2001, 17(10): 544-546.
18.	Martinez ME, O’brien TG, Fultz KE, et al. Pronounced reduction in adenoma recurrence associated with aspirin use and a polymorphism in the ornithine decarboxylase gene[J]. Proc Natl Acad Sci U S A, 2003, 100(13): 7859-7864.
19.	劉興, 高青, 馮文莉. 阿司匹林對胃癌細胞株SGC-7901的細胞毒作用[J]. 實用癌癥雜志, 2001, 16(4): 403-405.
20.	高雪芹, 張維東, 宋守芹, 等. 阿司匹林對S180腫瘤生長及血管生長相關因子表達的抑制作用[J]. 中國藥理學與毒理學雜志, 2002, 16(4): 299-301.
21.	Borthwick GM, Johnson AS, Partington M, et al. Therapeutic levels of aspirin and salicylate directly inhibit a model of angiogenesis through a Cox-independent mechanism[J]. FASEB J, 2006, 20(12): 2009-2016.
22.	Holmes MD, Chen WY, Li L, et al. Aspirin intake and survival after breast Cancer[J]. J Clin Oncol, 2010, 28(9): 1467-1472.
23.	Smalley W, Ray WA, Daugherty J, et al. Use of nonsteroidal anti-inflammatory drugs and incidence of colorectal cancer[J]. Arch Intern Med, 1999, 159(2): 161-166.
24.	陸維祺, 艾志龍, 沈兆忠. 阿司匹林對結腸癌細胞凋亡及Fas/FasL表達的影響[J]. 中國癌癥雜志, 2003, 13(4): 68-70.
25.	Rothwell PM, Fowkes FG, Belch JF, et al. Effect of daily aspirin on long-term risk of death due to Cancer: analysis of individual patient data from randomised trials[J]. Lancet, 2011, 377(9759): 31-41.
26.	Pignone M, Alberts MJ, Colwell JA, et al. Aspirin for primary prevention of cardiovascular events in People with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation[J]. Circulation, 2010, 33(6): 1395-1402.
27.	李文通, 王家耀, 劉兆華, 等. 阿司匹林對STZ糖尿病大鼠外周血白細胞iNOSmRNA和胰島細胞iNOS表達的影響[J]. 山東大學學報:醫學版, 2005, 43(10): 57-59,88.
28.	張雪勇, 劉穎妍, 張敏, 等. 羅格列酮聯合阿司匹林治療2型糖尿病伴胰島素抵抗大鼠的療效[J]. 中國新藥與臨床雜志, 2008, 27(9): 646-651.
29.	蔣曉真, 顧哲, 周斌, 等. 阿司匹林對2型糖尿病病人炎癥因子的影響[J]. 中國新藥與臨床雜志, 2009, 28(4): 297-300.
30.	高捷. 阿司匹林的臨床進展[J]. 寧波工程學院學報, 2005, 17(2): 54-56.
31.	陳新謙, 金有豫, 湯光. 新編藥物學[M]. 北京: 人民衛生出版社, 2007: 595.
32.	Pennisi E. Does aspirin ward off Cancer and alzheimer’s?[J]. Science, 1998, 280(5367): 1192-1192.
33.	Jones RW. Inflammation and alzheimer’s disease[J]. Lancet, 2001, 358(9280): 436-437.
34.	Raine CS. Inflammation in Alzheimer’s disease: a view from the periphery[J]. Neurobiol Aging, 2000, 21(3): 437-440.
35.	AD2000 Collaborative Group, Bentham P, et al. Aspirin in Alzheimer’s disease (AD2000): a randomized open-label trial[J]. Lancet Neurol, 2008, 7(1): 41-49.
36.	陳燕, 盧奕, 蔣永祥, 等. 阿司匹林對萘性白內障α-晶狀體蛋白分子伴侶活性的保護作用[J]. 眼科研究, 2010, 28(3): 221-224.
37.	喻繼兵, 周輝. 阿司匹林對半乳糖性白內障抑制作用的實驗研究[J]. 眼科研究, 2009, 27(11): 1015-1018.
38.	嚴宏, 張東杲, 楊新光. 阿斯匹林在防治白內障中的作用[J]. 中國實用眼科雜志, 1999, 17(10): 7-8.
39.	Swamy MS, Abraham EC. Inhibition of lens crystallin glycation and high molecular weight aggregate formation by aspirin in vitro and in vivo[J]. Invest Ophthalmol Vis Sci, 1989, 30(6): 1120-1126.
40.	Walsh SW, Wang Y. Secretion of lipid peroxides by the human placenta[J]. Am J Obstet Gynecol, 1993, 169(6): 1462-1466.
41.	Crompton M, Rixon KC, Harding JJ. Aspirin prevents carbamylation of soluble lens proteins and prevents cyanate-induced phase separation opacities in vitro: a possible mechanism by which aspirin could prevent cataract[J]. Exp Eye Res, 1985, 40(2): 297-311.
42.	Beswick HT, Harding JJ. Conformational changes induced in bovine lens alpha-crystallin by carbamylation. Relevance to cataract[J]. Biochem J, 1984, 223(1): 221-227.
43.	Jones RH, Hothersall JS. Increased susceptibility to metal catalysed oxidation of diabetic lens beta L crystallin: possible protection by dietary supplementation with acetylsalicylic acid[J]. Exp Eye Res, 1993, 57(6): 783-790.
44.	Powell ED, Field RA. Diabetic retinopathy and rheumatoid arthritis[J]. Lancet, 1964, 2(7349): 17-18.
45.	張永紅, 劉巧英. 低分子肝素聯合小劑量阿司匹林治療自身免疫型復發性流產的療效觀察[J]. 中國實用醫藥, 2011, 06(2): 62-63.
46.	張晉, 馮慧馨. 37例抗心磷脂抗體陽性的習慣性流產的治療[J]. 沈陽醫學院學報, 2010, 12(4): 206-207.
47.	Balasch J, Carmona F, López-Soto A, et al. Low-dose aspirin for prevention of pregnancy losses in women with primary antiphospholipid syndrome[J]. Hum Reprod, 1993, 8(12): 2234-2239.
48.	陳仕珠. 膽囊排空調節及功能性排空異常的診治進展[J]. 國外醫學:內科學分冊, 1999(8): 350-353.
49.	王亞非, 楊衛文, 楊景林. 阿司匹林對膽囊結石患者膽囊排空及結石形成影響的研究[J]. 中華消化雜志, 2001, 21(10): 634-635.
50.	Lee SP, Carey MC, Lamont JT. Aspirin prevention of cholesterol gallstone formation in prairie dogs[J]. Science, 1981, 211(4489): 1429-1431.
51.	褚志強, 尤承忠, 秦永林, 等. 炎癥和凝血活化亢進在倉鼠膽囊膽固醇結石形成中作用的實驗研究[J]. 中國病理生理雜志, 2005, 21(9): 1817-1820.
52.	柳長明, 于威, 劉銅軍. 腸溶阿司匹林治療老年腸運動功能異常性腹瀉的療效[J]. 中國老年學雜志, 2008, 28(3): 293-293.
53.	Mennie AT, Dalley V. Aspirin in radiation-induced diarrhoea[J]. Lancet, 1973, 1(7812): 1131.

1. 　楊寶峰. 藥理學[M]. 7版. 北京: 人民衛生出版社, 2008: 179-185.
2. 　Bitko V, Velazquez A, Yang L, et al. Transcriptional induction of multiple cytokines by human respiratory syncytial virus requires activation of NF-kappa B and is inhibited by Sodium salicylate and aspirin[J]. Virology, 1997, 232(2): 369-378.
3. 　郭振輝, 洪新, 毛寶齡, 等. 阿司匹林新的抗炎機制研究[J]. 中國危重病急救醫學, 2000, 12(10): 602-605.
4. 　Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients[J]. BMJ, 2002, 324(7329): 71-86.
5. 　Kim KM, Song JJ, An JY, et al. Pretreatment of acetylsalicylic acid promotes tumor necrosis factor-related apoptosis-inducing ligand-induced apoptosis by down-regulating BCL-2 gene expression[J]. J Biol Chem, 2005, 280(49): 41047-41056.
6. 　王振華. 淺析阿司匹林的臨床應用[J]. 基層醫學論壇, 2009, 13(14): 456-457.
7. 　胡健, 李夢. 阿司匹林在缺血性心臟病中的臨床應用與評價[J]. 藥品評價, 2009, 6(7): 270-272.
8. 　Collaborative Group of the Primary Prevention Project (PPP). Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomised trial in general practice[J]. Lancet, 2001, 357(9250): 89-95.
9. 　中華醫學會心血管病學分會, 中華心血管病雜志編輯委員會. 阿司匹林在動脈硬化性心血管病中的臨床應用: 中國專家共識(2005)[J]. 中華心血管病雜, 2006, 34(3): 281-284.
10. 　Bates ER, Lau WC. Controversies in antiplatelet therapy for patients with cardiovascular disease[J]. Circulation, 2005, 111(17): e267-e271.
11. 　Ridker PM, Cook NR, Lee IM, et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women[J]. N Engl J Med, 2005, 352(13): 1293-1304.
12. 　Steering Committee of the Physicians’ Health Study Research Group. Final report on the aspirin component of the ongoing Physicians’ Health Study[J]. N Engl J Med, 1989, 321(3): 129-135.
13. 　Peto R, Gray R, Collins R, et al. Randomised trial of prophylactic daily aspirin in British male doctors[J]. Br Med J, 1988, 296(6618): 313-316.
14. 　Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. HOT Study Group[J]. Lancet, 1998, 351(9118): 1755-1762.
15. 　王蓓, 秦英, 梅祖敏. 阿司匹林抗癌機制的研究進展[J]. 河北醫科大學學報, 2007, 28(4): 315-318.
16. 　李小安, 房殿春, 司佩任, 等. 腫瘤壞死因子相關配體與阿司匹林合用對肝癌SMMC-7721細胞凋亡的影響[J]. 中華肝臟病雜志, 2003, 11(11): 38-41.
17. 　夏琳, 丁紅, 劉芳, 等. 阿司匹林對膠質瘤細胞生長增殖及NOS表達的影響[J]. 中國免疫學雜志, 2001, 17(10): 544-546.
18. 　Martinez ME, O’brien TG, Fultz KE, et al. Pronounced reduction in adenoma recurrence associated with aspirin use and a polymorphism in the ornithine decarboxylase gene[J]. Proc Natl Acad Sci U S A, 2003, 100(13): 7859-7864.
19. 　劉興, 高青, 馮文莉. 阿司匹林對胃癌細胞株SGC-7901的細胞毒作用[J]. 實用癌癥雜志, 2001, 16(4): 403-405.
20. 　高雪芹, 張維東, 宋守芹, 等. 阿司匹林對S180腫瘤生長及血管生長相關因子表達的抑制作用[J]. 中國藥理學與毒理學雜志, 2002, 16(4): 299-301.
21. 　Borthwick GM, Johnson AS, Partington M, et al. Therapeutic levels of aspirin and salicylate directly inhibit a model of angiogenesis through a Cox-independent mechanism[J]. FASEB J, 2006, 20(12): 2009-2016.
22. 　Holmes MD, Chen WY, Li L, et al. Aspirin intake and survival after breast Cancer[J]. J Clin Oncol, 2010, 28(9): 1467-1472.
23. 　Smalley W, Ray WA, Daugherty J, et al. Use of nonsteroidal anti-inflammatory drugs and incidence of colorectal cancer[J]. Arch Intern Med, 1999, 159(2): 161-166.
24. 　陸維祺, 艾志龍, 沈兆忠. 阿司匹林對結腸癌細胞凋亡及Fas/FasL表達的影響[J]. 中國癌癥雜志, 2003, 13(4): 68-70.
25. 　Rothwell PM, Fowkes FG, Belch JF, et al. Effect of daily aspirin on long-term risk of death due to Cancer: analysis of individual patient data from randomised trials[J]. Lancet, 2011, 377(9759): 31-41.
26. 　Pignone M, Alberts MJ, Colwell JA, et al. Aspirin for primary prevention of cardiovascular events in People with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation[J]. Circulation, 2010, 33(6): 1395-1402.
27. 　李文通, 王家耀, 劉兆華, 等. 阿司匹林對STZ糖尿病大鼠外周血白細胞iNOSmRNA和胰島細胞iNOS表達的影響[J]. 山東大學學報:醫學版, 2005, 43(10): 57-59,88.
28. 　張雪勇, 劉穎妍, 張敏, 等. 羅格列酮聯合阿司匹林治療2型糖尿病伴胰島素抵抗大鼠的療效[J]. 中國新藥與臨床雜志, 2008, 27(9): 646-651.
29. 　蔣曉真, 顧哲, 周斌, 等. 阿司匹林對2型糖尿病病人炎癥因子的影響[J]. 中國新藥與臨床雜志, 2009, 28(4): 297-300.
30. 　高捷. 阿司匹林的臨床進展[J]. 寧波工程學院學報, 2005, 17(2): 54-56.
31. 　陳新謙, 金有豫, 湯光. 新編藥物學[M]. 北京: 人民衛生出版社, 2007: 595.
32. 　Pennisi E. Does aspirin ward off Cancer and alzheimer’s?[J]. Science, 1998, 280(5367): 1192-1192.
33. 　Jones RW. Inflammation and alzheimer’s disease[J]. Lancet, 2001, 358(9280): 436-437.
34. 　Raine CS. Inflammation in Alzheimer’s disease: a view from the periphery[J]. Neurobiol Aging, 2000, 21(3): 437-440.
35. 　AD2000 Collaborative Group, Bentham P, et al. Aspirin in Alzheimer’s disease (AD2000): a randomized open-label trial[J]. Lancet Neurol, 2008, 7(1): 41-49.
36. 　陳燕, 盧奕, 蔣永祥, 等. 阿司匹林對萘性白內障α-晶狀體蛋白分子伴侶活性的保護作用[J]. 眼科研究, 2010, 28(3): 221-224.
37. 　喻繼兵, 周輝. 阿司匹林對半乳糖性白內障抑制作用的實驗研究[J]. 眼科研究, 2009, 27(11): 1015-1018.
38. 　嚴宏, 張東杲, 楊新光. 阿斯匹林在防治白內障中的作用[J]. 中國實用眼科雜志, 1999, 17(10): 7-8.
39. 　Swamy MS, Abraham EC. Inhibition of lens crystallin glycation and high molecular weight aggregate formation by aspirin in vitro and in vivo[J]. Invest Ophthalmol Vis Sci, 1989, 30(6): 1120-1126.
40. 　Walsh SW, Wang Y. Secretion of lipid peroxides by the human placenta[J]. Am J Obstet Gynecol, 1993, 169(6): 1462-1466.
41. 　Crompton M, Rixon KC, Harding JJ. Aspirin prevents carbamylation of soluble lens proteins and prevents cyanate-induced phase separation opacities in vitro: a possible mechanism by which aspirin could prevent cataract[J]. Exp Eye Res, 1985, 40(2): 297-311.
42. 　Beswick HT, Harding JJ. Conformational changes induced in bovine lens alpha-crystallin by carbamylation. Relevance to cataract[J]. Biochem J, 1984, 223(1): 221-227.
43. 　Jones RH, Hothersall JS. Increased susceptibility to metal catalysed oxidation of diabetic lens beta L crystallin: possible protection by dietary supplementation with acetylsalicylic acid[J]. Exp Eye Res, 1993, 57(6): 783-790.
44. 　Powell ED, Field RA. Diabetic retinopathy and rheumatoid arthritis[J]. Lancet, 1964, 2(7349): 17-18.
45. 　張永紅, 劉巧英. 低分子肝素聯合小劑量阿司匹林治療自身免疫型復發性流產的療效觀察[J]. 中國實用醫藥, 2011, 06(2): 62-63.
46. 　張晉, 馮慧馨. 37例抗心磷脂抗體陽性的習慣性流產的治療[J]. 沈陽醫學院學報, 2010, 12(4): 206-207.
47. 　Balasch J, Carmona F, López-Soto A, et al. Low-dose aspirin for prevention of pregnancy losses in women with primary antiphospholipid syndrome[J]. Hum Reprod, 1993, 8(12): 2234-2239.
48. 　陳仕珠. 膽囊排空調節及功能性排空異常的診治進展[J]. 國外醫學:內科學分冊, 1999(8): 350-353.
49. 　王亞非, 楊衛文, 楊景林. 阿司匹林對膽囊結石患者膽囊排空及結石形成影響的研究[J]. 中華消化雜志, 2001, 21(10): 634-635.
50. 　Lee SP, Carey MC, Lamont JT. Aspirin prevention of cholesterol gallstone formation in prairie dogs[J]. Science, 1981, 211(4489): 1429-1431.
51. 　褚志強, 尤承忠, 秦永林, 等. 炎癥和凝血活化亢進在倉鼠膽囊膽固醇結石形成中作用的實驗研究[J]. 中國病理生理雜志, 2005, 21(9): 1817-1820.
52. 　柳長明, 于威, 劉銅軍. 腸溶阿司匹林治療老年腸運動功能異常性腹瀉的療效[J]. 中國老年學雜志, 2008, 28(3): 293-293.
53. 　Mennie AT, Dalley V. Aspirin in radiation-induced diarrhoea[J]. Lancet, 1973, 1(7812): 1131.

《華西醫學》

阿司匹林的臨床應用進展

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《華西醫學》

阿司匹林的臨床應用進展

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

摘要全文圖表視頻參考文獻施引文獻補充材料