与长期使用质子抑制剂相关的不良影响
1Dubai Academic Health Corporation, Dubai, UAE.
Chonnam medical journal
|June 12, 2023
概括
长期使用质子抑制剂 (PPI) 与严重的不良影响有关,包括脏疾病,心血管风险,骨折,感染和营养缺乏. 医疗保健提供者应对患者进行监测,并考虑在没有明确指示的情况下停止处方PPI.
科学领域:
- 胃肠病学和内科医学
背景情况:
- 质子抑制剂 (PPI) 在全球范围内广泛用于各种与酸有关的胃肠道疾病.
- 长期使用PPI是常见的,需要对相关风险进行审查.
研究的目的:
- 审查和总结与长期使用质子抑制剂相关的不良影响.
- 为临床医生和患者提供有关潜在风险和管理策略的信息.
主要方法:
- 对观察性研究,临床试验和元分析进行全面的审查.
- 综合了与长期PPI治疗相关的已确定的不良影响.
主要成果:
- 确定的不良影响包括脏疾病 (AKI,CKD),心血管风险 (MACE,中风),骨折,感染 (C. difficile,肺炎) 和微量营养素缺乏 (低血症,B12缺乏).
- 其他风险包括胃高血症,各种癌症 (胃癌,胰腺癌),肝脑病和痴呆症.
- 美国胃肠道学会 (AGA) 的指导方针建议在没有迹象的情况下采取非药物治疗措施,H2阻断剂和PPI降低处方.
结论:
- 临床医生和药剂师必须意识到长期使用PPE的各种不良影响.
- 对这些不良反应的患者监测至关重要.
- 建议遵守 AGA 的指导方针,包括在适当时停止处方 PPI,以减轻风险.
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