非ステロイド性抗炎症薬が,骨格関節炎の進行に及ぼす影響
S Rashad1, P Revell, A Hemingway
1West Middlesex University Hospital.
Lancet (London, England)
|September 2, 1989
まとめ
非ステロイド性抗炎症薬 (NSAIDs) は,血流を減少させることにより,骨格関節炎を悪化させる可能性があります. インドメタシンのような強力なNSAIDは,股関節関節炎患者の関節のスペース損失を加速させた.
科学分野:
- レウマトロジーの病理学
- 薬理学 薬理学とは
- バイオケミストリー バイオケミストリー
背景:
- 骨格関節炎 (OA) は,軟骨の分解によって特徴づけられる変性関節疾患です.
- 非ステロイド性抗炎症薬 (NSAIDs) は,OAの痛みを管理するために一般的に使用されます.
- この仮説は,NSAIDsが血管拡張性プロスタグランディンを阻害し,関節 perfusion を減少させることで,OAの進行を加速させることを示唆しています.
研究 の 目的:
- NSAIDが骨格関節炎の進行を加速するかどうかを調査する.
- プロスタグランディン合成阻害が関節 perfusion と OA の進行に及ぼす影響を決定する.
- 股関節OA患者の強い (インドメタシン) と弱い (アザプロパゾン) プロスタグランジン合成阻害剤の効果を比較する.
主な方法:
- ヒップ関節整形手術を待っている105人の骨関節炎患者の将来性研究.
- インドメタシン (強い阻害剤) またはアザプロパゾン (弱い阻害剤) で治療された患者.
- 切断された股関節の頭部における痛み,放射線学的関節空間,および組織病理学的状態のモニタリング.
主要な成果:
- 両治療群とも,関節整形手術で同様の病理生理学的エンドポイントに達した.
- インドメタシン群は,逆側股関節と比較して,影響を受けた股関節の関節空間喪失がより迅速であることが示されました.
- アザプロパゾン群は,シナヴィアル血管拡張性プロスタグランディンが高かったため,進行が遅いようになり,エンドポイントに到達するのに時間がかかりました.
結論:
- プロスタグランジン合成の強力な阻害は,股関節関節炎の管理に有害である可能性があります.
- プロスタグランジン合成を強く阻害するNSAIDは,関節 perfusion を減らすことでOAの進行を加速する可能性があります.
- 弱いプロスタグランジン合成阻害剤は,股関節OA管理により適している可能性があります.
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