服用非甾体抗炎药（NSAID）是否会增加心脏病发作或卒中的风险？
回答 Rekha Mankad, M.D.
是。通常用于治疗疼痛和炎症的非甾体抗炎药（NSAID）可能增加心脏病发作或卒中的风险。心脏病患者和未患心脏病的人群都会受到风险增加的影响。然而，这一风险在心脏病患者中更高。
NSAID 无需处方即可购买。一些 NSAID 仅可凭处方购买。NSAID 包括布洛芬（Advil、Motrin IB 等）、萘普生纳（Aleve、Anaprox DS 等）、双氯芬酸钠和塞来昔布（Celebrex）。
如需服用 NSAID，请尽量缩短服药时间，且选择最低剂量，以限制心脏病发作或卒中的风险。对大多数人而言，偶尔服用 NSAID 是安全的。但请注意，如果每日服用 NSAID，前几周就可能会出现严重副作用。服药时间越长，风险就越大。
为缓解肌肉或关节疼痛，在服用 NSAID 之前，您可以考虑先尝试其他疗法，例如热敷、冷敷或物理疗法。您的医务人员可能会建议使用其他药物缓解一般疼痛，如对乙酰氨基酚（Tylenol 等）。如果您患有 COVID-19，没有证据表明需要避免使用布洛芬或其他非甾体抗炎药（NSAID）。
阿司匹林似乎与心脏病发作或卒中风险升高无关。如果您正服用阿司匹林来帮助预防心脏病发作，请在服用 NSAID 之前咨询您的医务人员。有些 NSAID 会与阿司匹林相互作用，影响其预防心脏病发作的效果。
如果您出现心脏病发作或卒中的体征或症状，例如胸部疼痛、气短、身体某一部分或身体一侧虚弱或者突然出现言语不清，请立即就医。
显示参考文献
- FDA Drug Safety Communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/ucm451800.htm. Accessed Nov. 9, 2020.
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- NSAIDs and the risk of heart problems and stroke. Arthritis Foundation. https://www.arthritis.org/health-wellness/treatment/treatment-plan/disease-management/nsaids-risk-of-heart-problems-and-stroke. Accessed Nov. 9, 2020.
- Information about taking ibuprofen and aspirin together. U.S. Food and Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/information-about-taking-ibuprofen-and-aspirin-together. Accessed Nov. 13, 2020.
- Schjerning AM, et al. Cardiovascular effects and safety of (nonaspirin) NSAIDs. Nature Reviews Cardiology. 2020; doi:10.1038/s41569-020-0366-z.
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Original article: https://www.mayoclinic.org/zh-hans/diseases-conditions/heart-attack/expert-answers/nsaids-heart-attack-stroke/faq-20147557