质子抑制剂的使用和肺炎的风险:一个自我控制的案例系列研究研究
John Maret-Ouda1,2, Joni Panula2,3, Giola Santoni3
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Journal of gastroenterology
|June 14, 2023
概括
质子抑制剂 (PPI) 的使用与肺炎风险增加73%有关. 这项研究建议在处方PPI时谨慎行事,特别是对于有肺炎病史的患者.
科学领域:
- 胃肠病学 胃肠病学
- 肺部病理学 肺部病理学
- 药物监督 药物监督 药物监督
背景情况:
- 以前的研究表明,质子抑制剂 (PPI) 使用与肺炎之间存在联系,但由于方法上的局限性,研究结果尚未确定.
- 现有证据缺乏对混因素的强有力的控制,需要进一步调查潜在的因果关系.
研究的目的:
- 确定PPI使用是否会增加肺炎风险,解决先前研究的方法问题.
- 为了更清楚地了解PPI治疗与肺炎发病率之间的关联.
主要方法:
- 一个基于人口的,全国性的瑞典自控病例系列研究 (2005-2019) 使用国家注册数据.
- 条件固定效应的波松回归分析了肺炎的发病率比率 (IRR),比较了个人中的PPI暴露和未暴露时期.
- 根据治疗持续时间,人口统计和吸烟相关疾病进行分层分析,并对类型-2 基因组胺受体抗剂的使用进行了比较分析.
主要成果:
- 使用PPI与肺炎风险增加73%有关 (IRR为1.73,95% CI为1.71-1.75).
- 在各种PPI治疗持续时间,年龄组,性别以及吸烟相关疾病患者中观察到肺炎风险增加.
- 使用胺2-型受体对抗剂与肺炎风险的相关性较弱 (IRR 1.08,95% CI 1.02-1.14).
结论:
- 质子抑制剂的使用似乎与肺炎的风险增加有关.
- 这些发现强调了在开处方PPI时谨慎采取措施的重要性,特别是在有肺炎病史的人群中.
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