阿司匹林的临床应用进展_West China Medical Journal

Authors：

李才正 ,  苗佳

Corresponding author：

苗佳, Email: li120815495@163.com

Keywords：

阿司匹林; 临床应用; 进展

Video：

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阿司匹林是临床处方量最大的常用药物，其治疗作用随剂量不同而不同，具有良好的解热、镇痛、抗炎以及血小板聚集抑制作用等。随着对该药研究的深入，近年来又发现了阿司匹林的一些新应用，包括癌症预防、糖尿病防治、缓解白内障等，但这些新应用尚需临床进一步研究才能得以推广。现主要针对阿司匹林的临床应用进展进行综述。

Citation： 李才正,苗佳. 阿司匹林的临床应用进展. West China Medical Journal, 2012, 27(7): 988-991. doi: Copy

1.	杨宝峰. 药理学[M]. 7版. 北京: 人民卫生出版社, 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.	郭振辉, 洪新, 毛宝龄, 等. 阿司匹林新的抗炎机制研究[J]. 中国危重病急救医学, 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.	王振华. 浅析阿司匹林的临床应用[J]. 基层医学论坛, 2009, 13(14): 456-457.
7.	胡健, 李梦. 阿司匹林在缺血性心脏病中的临床应用与评价[J]. 药品评价, 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.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 阿司匹林在动脉硬化性心血管病中的临床应用: 中国专家共识(2005)[J]. 中华心血管病杂, 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. 阿司匹林抗癌机制的研究进展[J]. 河北医科大学学报, 2007, 28(4): 315-318.
16.	李小安, 房殿春, 司佩任, 等. 肿瘤坏死因子相关配体与阿司匹林合用对肝癌SMMC-7721细胞凋亡的影响[J]. 中华肝脏病杂志, 2003, 11(11): 38-41.
17.	夏琳, 丁红, 刘芳, 等. 阿司匹林对胶质瘤细胞生长增殖及NOS表达的影响[J]. 中国免疫学杂志, 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.	刘兴, 高青, 冯文莉. 阿司匹林对胃癌细胞株SGC-7901的细胞毒作用[J]. 实用癌症杂志, 2001, 16(4): 403-405.
20.	高雪芹, 张维东, 宋守芹, 等. 阿司匹林对S180肿瘤生长及血管生长相关因子表达的抑制作用[J]. 中国药理学与毒理学杂志, 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.	陆维祺, 艾志龙, 沈兆忠. 阿司匹林对结肠癌细胞凋亡及Fas/FasL表达的影响[J]. 中国癌症杂志, 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, 刘兆华, 等. 阿司匹林对STZ糖尿病大鼠外周血白细胞iNOSmRNA和胰岛细胞iNOS表达的影响[J]. 山东大学学报:医学版, 2005, 43(10): 57-59,88.
28.	张雪勇, 刘颖妍, 张敏, 等. 罗格列酮联合阿司匹林治疗2型糖尿病伴胰岛素抵抗大鼠的疗效[J]. 中国新药与临床杂志, 2008, 27(9): 646-651.
29.	蒋晓真, 顾哲, 周斌, 等. 阿司匹林对2型糖尿病病人炎症因子的影响[J]. 中国新药与临床杂志, 2009, 28(4): 297-300.
30.	高捷. 阿司匹林的临床进展[J]. 宁波工程学院学报, 2005, 17(2): 54-56.
31.	陈新谦, 金有豫, 汤光. 新编药物学[M]. 北京: 人民卫生出版社, 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.	陈燕, 卢奕, 蒋永祥, 等. 阿司匹林对萘性白内障α-晶状体蛋白分子伴侣活性的保护作用[J]. 眼科研究, 2010, 28(3): 221-224.
37.	喻继兵, 周辉. 阿司匹林对半乳糖性白内障抑制作用的实验研究[J]. 眼科研究, 2009, 27(11): 1015-1018.
38.	严宏, 张东杲, 杨新光. 阿斯匹林在防治白内障中的作用[J]. 中国实用眼科杂志, 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.	张永红, 刘巧英. 低分子肝素联合小剂量阿司匹林治疗自身免疫型复发性流产的疗效观察[J]. 中国实用医药, 2011, 06(2): 62-63.
46.	张晋, 冯慧馨. 37例抗心磷脂抗体阳性的习惯性流产的治疗[J]. 沈阳医学院学报, 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.	陈仕珠. 胆囊排空调节及功能性排空异常的诊治进展[J]. 国外医学:内科学分册, 1999(8): 350-353.
49.	王亚非, 杨卫文, 杨景林. 阿司匹林对胆囊结石患者胆囊排空及结石形成影响的研究[J]. 中华消化杂志, 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.	褚志强, 尤承忠, 秦永林, 等. 炎症和凝血活化亢进在仓鼠胆囊胆固醇结石形成中作用的实验研究[J]. 中国病理生理杂志, 2005, 21(9): 1817-1820.
52.	柳长明, 于威, 刘铜军. 肠溶阿司匹林治疗老年肠运动功能异常性腹泻的疗效[J]. 中国老年学杂志, 2008, 28(3): 293-293.
53.	Mennie AT, Dalley V. Aspirin in radiation-induced diarrhoea[J]. Lancet, 1973, 1(7812): 1131.

1. 　杨宝峰. 药理学[M]. 7版. 北京: 人民卫生出版社, 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. 　郭振辉, 洪新, 毛宝龄, 等. 阿司匹林新的抗炎机制研究[J]. 中国危重病急救医学, 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. 　王振华. 浅析阿司匹林的临床应用[J]. 基层医学论坛, 2009, 13(14): 456-457.
7. 　胡健, 李梦. 阿司匹林在缺血性心脏病中的临床应用与评价[J]. 药品评价, 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. 　中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 阿司匹林在动脉硬化性心血管病中的临床应用: 中国专家共识(2005)[J]. 中华心血管病杂, 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. 阿司匹林抗癌机制的研究进展[J]. 河北医科大学学报, 2007, 28(4): 315-318.
16. 　李小安, 房殿春, 司佩任, 等. 肿瘤坏死因子相关配体与阿司匹林合用对肝癌SMMC-7721细胞凋亡的影响[J]. 中华肝脏病杂志, 2003, 11(11): 38-41.
17. 　夏琳, 丁红, 刘芳, 等. 阿司匹林对胶质瘤细胞生长增殖及NOS表达的影响[J]. 中国免疫学杂志, 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. 　刘兴, 高青, 冯文莉. 阿司匹林对胃癌细胞株SGC-7901的细胞毒作用[J]. 实用癌症杂志, 2001, 16(4): 403-405.
20. 　高雪芹, 张维东, 宋守芹, 等. 阿司匹林对S180肿瘤生长及血管生长相关因子表达的抑制作用[J]. 中国药理学与毒理学杂志, 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. 　陆维祺, 艾志龙, 沈兆忠. 阿司匹林对结肠癌细胞凋亡及Fas/FasL表达的影响[J]. 中国癌症杂志, 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, 刘兆华, 等. 阿司匹林对STZ糖尿病大鼠外周血白细胞iNOSmRNA和胰岛细胞iNOS表达的影响[J]. 山东大学学报:医学版, 2005, 43(10): 57-59,88.
28. 　张雪勇, 刘颖妍, 张敏, 等. 罗格列酮联合阿司匹林治疗2型糖尿病伴胰岛素抵抗大鼠的疗效[J]. 中国新药与临床杂志, 2008, 27(9): 646-651.
29. 　蒋晓真, 顾哲, 周斌, 等. 阿司匹林对2型糖尿病病人炎症因子的影响[J]. 中国新药与临床杂志, 2009, 28(4): 297-300.
30. 　高捷. 阿司匹林的临床进展[J]. 宁波工程学院学报, 2005, 17(2): 54-56.
31. 　陈新谦, 金有豫, 汤光. 新编药物学[M]. 北京: 人民卫生出版社, 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. 　陈燕, 卢奕, 蒋永祥, 等. 阿司匹林对萘性白内障α-晶状体蛋白分子伴侣活性的保护作用[J]. 眼科研究, 2010, 28(3): 221-224.
37. 　喻继兵, 周辉. 阿司匹林对半乳糖性白内障抑制作用的实验研究[J]. 眼科研究, 2009, 27(11): 1015-1018.
38. 　严宏, 张东杲, 杨新光. 阿斯匹林在防治白内障中的作用[J]. 中国实用眼科杂志, 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. 　张永红, 刘巧英. 低分子肝素联合小剂量阿司匹林治疗自身免疫型复发性流产的疗效观察[J]. 中国实用医药, 2011, 06(2): 62-63.
46. 　张晋, 冯慧馨. 37例抗心磷脂抗体阳性的习惯性流产的治疗[J]. 沈阳医学院学报, 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. 　陈仕珠. 胆囊排空调节及功能性排空异常的诊治进展[J]. 国外医学:内科学分册, 1999(8): 350-353.
49. 　王亚非, 杨卫文, 杨景林. 阿司匹林对胆囊结石患者胆囊排空及结石形成影响的研究[J]. 中华消化杂志, 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. 　褚志强, 尤承忠, 秦永林, 等. 炎症和凝血活化亢进在仓鼠胆囊胆固醇结石形成中作用的实验研究[J]. 中国病理生理杂志, 2005, 21(9): 1817-1820.
52. 　柳长明, 于威, 刘铜军. 肠溶阿司匹林治疗老年肠运动功能异常性腹泻的疗效[J]. 中国老年学杂志, 2008, 28(3): 293-293.
53. 　Mennie AT, Dalley V. Aspirin in radiation-induced diarrhoea[J]. Lancet, 1973, 1(7812): 1131.

West China Medical Journal

阿司匹林的临床应用进展

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