Am J Gastroenterol:使用质子泵抑制剂会增加中风风险

2017-04-25 zhangfan MedSci原创

使用质子泵抑制剂增加了第一次缺血性中风的风险,并且该风险与抗血小板药物不相关

有报道称同时服用质子泵抑制剂(PPI)和抗血小板药物患者的心血管不良事件风险增加。近日研究人员针对这一报道验证了服用质子泵抑制剂与首次中风之间的关系。

这是一项回顾性研究,使用来自台湾健康保险的数据库,参与个体的年龄大于20岁。对1:1的质子泵抑制服用患者与非服用患者进行倾向评分相匹配并对中风患者进行嵌套的案例-控制分析。研究的主要终点是在120天随访期间缺血性卒中住院风险。

研究的倾向评分匹配分析包括了198148名患者。质子泵抑制剂的使用与缺血性卒中住院有高风险,危险比1.36(95% CI 1.14-1.62 P=0.001)。亚组分析显示,年龄低于60岁的患者对质子泵抑制剂更敏感(P=0.043),但性别、心肌梗塞史、糖尿病高血压、非甾体类抗血小板药物或质子泵抑制剂种类对该风险没有影响。在嵌套的案例-控制分析中,15378因中风住院患者与对照患者进行比较确证了使用质子泵抑制剂与脑血管风险,30天质子泵抑制剂导致的首次中风调整后风险比为1.77,31天至90天为1.65,91天至180天为1.28。

研究认为,使用质子泵抑制剂增加了第一次缺血性中风的风险,并且该风险与抗血小板药物不相关。实际临床应用中,应适度考虑相关风险,特别是对于中风风险较高的患者。

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    2017-11-13 jklm09
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    2017-07-03 许安
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