• 四川大學(xué)華西醫(yī)院國家藥物臨床試驗機(jī)構(gòu)·GCP中心（成都，610041）;

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(zhèn)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(fā)現(xiàn)了阿司匹林的一些新應(yīng)用，包括癌癥預(yù)防、糖尿病防治、緩解白內(nèi)障等，但這些新應(yīng)用尚需臨床進(jìn)一步研究才能得以推廣?，F(xiàn)主要針對阿司匹林的臨床應(yīng)用進(jìn)展進(jìn)行綜述。

引用本文： 李才正,苗佳. 阿司匹林的臨床應(yīng)用進(jìn)展. 華西醫(yī)學(xué), 2012, 27(7): 988-991. doi: 復(fù)制

1. 　楊寶峰. 藥理學(xué)[M]. 7版. 北京: 人民衛(wèi)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(jī)制研究[J]. 中國危重病急救醫(yī)學(xué), 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(yīng)用[J]. 基層醫(yī)學(xué)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(yīng)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(yī)學(xué)會心血管病學(xué)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(yīng)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(jī)制的研究進(jìn)展[J]. 河北醫(yī)科大學(xué)學(xué)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(guān)配體與阿司匹林合用對肝癌SMMC-7721細(xì)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(zhì)瘤細(xì)胞生長增殖及NOS表達(dá)的影響[J]. 中國免疫學(xué)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(xì)胞株SGC-7901的細(xì)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(guān)因子表達(dá)的抑制作用[J]. 中國藥理學(xué)與毒理學(xué)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(jié)腸癌細(xì)胞凋亡及Fas/FasL表達(dá)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(xì)胞iNOSmRNA和胰島細(xì)胞iNOS表達(dá)的影響[J]. 山東大學(xué)學(xué)報:醫(yī)學(xué)版, 2005, 43(10): 57-59,88.
28. 　張雪勇, 劉穎妍, 張敏, 等. 羅格列酮聯(lián)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(jìn)展[J]. 寧波工程學(xué)院學(xué)報, 2005, 17(2): 54-56.
31. 　陳新謙, 金有豫, 湯光. 新編藥物學(xué)[M]. 北京: 人民衛(wèi)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(nèi)障α-晶狀體蛋白分子伴侶活性的保護(hù)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(nèi)障抑制作用的實驗研究[J]. 眼科研究, 2009, 27(11): 1015-1018.
38. 　嚴(yán)宏, 張東杲, 楊新光. 阿斯匹林在防治白內(nèi)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(lián)合小劑量阿司匹林治療自身免疫型復(fù)發(fā)性流產(chǎn)的療效觀察[J]. 中國實用醫(yī)藥, 2011, 06(2): 62-63.
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  1. 1. 　楊寶峰. 藥理學(xué)[M]. 7版. 北京: 人民衛(wèi)生出版社, 2008: 179-185.
  2. 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. 3. 　郭振輝, 洪新, 毛寶齡, 等. 阿司匹林新的抗炎機(jī)制研究[J]. 中國危重病急救醫(yī)學(xué), 2000, 12(10): 602-605.
  4. 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. 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. 6. 　王振華. 淺析阿司匹林的臨床應(yīng)用[J]. 基層醫(yī)學(xué)論壇, 2009, 13(14): 456-457.
  7. 7. 　胡健, 李夢. 阿司匹林在缺血性心臟病中的臨床應(yīng)用與評價[J]. 藥品評價, 2009, 6(7): 270-272.
  8. 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. 9. 　中華醫(yī)學(xué)會心血管病學(xué)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(yīng)用: 中國專家共識(2005)[J]. 中華心血管病雜, 2006, 34(3): 281-284.
  10. 10. 　Bates ER, Lau WC. Controversies in antiplatelet therapy for patients with cardiovascular disease[J]. Circulation, 2005, 111(17): e267-e271.
  11. 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. 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. 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. 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. 15. 　王蓓, 秦英, 梅祖敏. 阿司匹林抗癌機(jī)制的研究進(jìn)展[J]. 河北醫(yī)科大學(xué)學(xué)報, 2007, 28(4): 315-318.
  16. 16. 　李小安, 房殿春, 司佩任, 等. 腫瘤壞死因子相關(guān)配體與阿司匹林合用對肝癌SMMC-7721細(xì)胞凋亡的影響[J]. 中華肝臟病雜志, 2003, 11(11): 38-41.
  17. 17. 　夏琳, 丁紅, 劉芳, 等. 阿司匹林對膠質(zhì)瘤細(xì)胞生長增殖及NOS表達(dá)的影響[J]. 中國免疫學(xué)雜志, 2001, 17(10): 544-546.
  18. 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. 19. 　劉興, 高青, 馮文莉. 阿司匹林對胃癌細(xì)胞株SGC-7901的細(xì)胞毒作用[J]. 實用癌癥雜志, 2001, 16(4): 403-405.
  20. 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(guān)因子表達(dá)的抑制作用[J]. 中國藥理學(xué)與毒理學(xué)雜志, 2002, 16(4): 299-301.
  21. 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. 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. 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. 24. 　陸維祺, 艾志龍, 沈兆忠. 阿司匹林對結(jié)腸癌細(xì)胞凋亡及Fas/FasL表達(dá)的影響[J]. 中國癌癥雜志, 2003, 13(4): 68-70.
  25. 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. 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. 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(xì)胞iNOSmRNA和胰島細(xì)胞iNOS表達(dá)的影響[J]. 山東大學(xué)學(xué)報:醫(yī)學(xué)版, 2005, 43(10): 57-59,88.
  28. 28. 　張雪勇, 劉穎妍, 張敏, 等. 羅格列酮聯(lián)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. 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. 30. 　高捷. 阿司匹林的臨床進(jìn)展[J]. 寧波工程學(xué)院學(xué)報, 2005, 17(2): 54-56.
  31. 31. 　陳新謙, 金有豫, 湯光. 新編藥物學(xué)[M]. 北京: 人民衛(wèi)生出版社, 2007: 595.
  32. 32. 　Pennisi E. Does aspirin ward off Cancer and alzheimer’s?[J]. Science, 1998, 280(5367): 1192-1192.
  33. 33. 　Jones RW. Inflammation and alzheimer’s disease[J]. Lancet, 2001, 358(9280): 436-437.
  34. 34. 　Raine CS. Inflammation in Alzheimer’s disease: a view from the periphery[J]. Neurobiol Aging, 2000, 21(3): 437-440.
  35. 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. 36. 　陳燕, 盧奕, 蔣永祥, 等. 阿司匹林對萘性白內(nèi)障α-晶狀體蛋白分子伴侶活性的保護(hù)作用[J]. 眼科研究, 2010, 28(3): 221-224.
  37. 37. 　喻繼兵, 周輝. 阿司匹林對半乳糖性白內(nèi)障抑制作用的實驗研究[J]. 眼科研究, 2009, 27(11): 1015-1018.
  38. 38. 　嚴(yán)宏, 張東杲, 楊新光. 阿斯匹林在防治白內(nèi)障中的作用[J]. 中國實用眼科雜志, 1999, 17(10): 7-8.
  39. 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. 40. 　Walsh SW, Wang Y. Secretion of lipid peroxides by the human placenta[J]. Am J Obstet Gynecol, 1993, 169(6): 1462-1466.
  41. 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. 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. 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.
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