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尼美舒利是非甾体类抗炎药,为选择性环氧化酶-2(COX-2)抑制剂,其耐受性好,不良反应尤其是胃肠道不良反应少。近年,尼美舒利引致肝脏损害,甚至死亡,而在一些国家停止销售。然而,欧洲药品管理局对尼美舒利进行安全性评估后认为,其利益大于风险,但需限制其使用。尼美舒利致肝脏损害的发病机制尚不清楚,可能和免疫及个体代谢差异有关。预防尼美舒利肝脏损害的措施为:严格掌握适应证;疗程应限制在15d之内;避免大剂量用药和联合用药;高龄和女性患者慎用,儿童尽量不用;用药>1周应监测肝功能。
Nimesulide is a non-steroidal anti-inflammatory drug, a selective cyclooxygenase-2 (COX-2) inhibitor, which is well tolerated, adverse reactions, especially gastrointestinal adverse reactions. In recent years, nimesulide has caused liver damage, and even death, while sales have ceased in some countries. However, the European Medicines Agency’s safety assessment of nimesulide believes that its benefits outweigh the risks but limit its use. The pathogenesis of nimesulide-induced liver damage is not clear, and may be related to immune and individual metabolic differences. Prevention of nimesulide liver damage measures: strict indications; treatment should be limited to 15d; to avoid high-dose medication and combination therapy; caution in elderly and female patients, children try not to use; medication> 1 week should be monitored liver Features.