thiazide 利尿剂和部骨折的风险. 来自弗雷明汉研究的结果
D T Felson1, D Sloutskis, J J Anderson
1Boston University Arthritis Center, Boston University School of Medicine, MA 02118.
JAMA
|January 16, 1991
概括
最近使用纯 thiazide 利尿剂,而不是组合药物,显著保护绝经后妇女免受骨折. 过去的化物使用没有提供保护,这表明当前药物的重要性.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 整形外科 整形外科 整形外科
背景情况:
- thiazide 利尿剂正在研究其在老年妇女中保持骨质和预防骨质疏松性骨折的潜力.
- 以前的研究没有区分各种 thiazide 制剂,也没有评估之前使用 thiazide 的影响.
研究的目的:
- 调查在绝经后妇女中使用 thiazide 利尿剂与关节骨折风险之间的关联.
- 为了确定特定的 thiazide 配方 (纯与组合) 或使用时间是否会影响骨折预防.
主要方法:
- 进行了一项病例控制研究,使用了弗雷明汉研究队列的绝经后女性成员.
- 首次部骨折的病例 (n=176) 与年龄匹配的对照组 (n=672) 相比较.
- 对 thiazide 的使用 (最近的纯,最近的组合,以前的) 进行了评估,以评估部骨折的发生率.
主要成果:
- 任何最近使用的 thiazide 都显示出对关节骨折的不显著的适度保护作用.
- 最近使用纯 thiazide 利尿剂表明显著的保护 (调整后的几率比,0.31; 95% CI,0.11-0.88).
- 最近使用综合性 thiazide 药物没有提供保护 (调整的几率比,1.16;95% CI,0.44-3.05),可能是由于较低的化胺剂量.
结论:
- 最近,不间断使用纯 thiazide 利尿剂与更年期后妇女关节骨折风险降低有关.
- 含有 thiazides 的组合利尿剂,特别是较低剂量的产品,可能无法提供相同的骨保护效果.
- 暂停 thiazide 治疗会消除对部骨折风险的任何观察到的保护作用.
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