长期使用质子抑制剂的胃癌风险:基于人口的队列研究
Jong Wook Kim1, Hye-Kyung Jung2, Bora Lee3
1Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
European journal of clinical pharmacology
|October 20, 2023
概括
在Helicobacter pylori根除后,长期使用质子抑制剂 (PPI) 会增加胃癌的风险,特别是高剂量. 在使用者和非使用者之间,死亡率仍然相似.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 质子抑制剂 (PPI) 广泛用于与酸有关的胃肠道疾病.
- 长期使用PPI已被调查,以确定与各种健康结果的潜在关联.
- 胃癌 (GC) 仍然是一个重大的健康问题,特别是在患病率高的地区.
研究的目的:
- 为了确定长期使用质子抑制剂 (PPI) 是否与胃癌 (GC) 的风险增加有关.
- 调查PPI暴露和GC发育之间的剂量反应关系.
- 为了比较长期PPI使用者和非使用者在Helicobacter pylori根除后的死亡率.
主要方法:
- 一项使用韩国国家医疗保险服务数据库 (2009-2019) 的全国性队列研究.
- 包括40岁以上的患者,他们在2009-2014年期间接受了Helicobacter pylori根除 (HPE) 治疗.
- 倾向性得分匹配用于比较PPI用户 (≥180cDDD) 和非用户之间的GC发病率和死亡率,根据随访时间和PPI剂量分层分析.
主要成果:
- 总共有144,091对PPI用户和非用户的匹配对被分析.
- 长期使用PPI与GC风险显著增加有关 (aHR:1.15;95% CI,1.06-1.25).
- 观察到一种积极的剂量反应关系,每年PPI剂量最高的三位数显示出明显更高的GC风险 (aHR:3.87;95% CI,3.25-4.60). 与GC相关的死亡率没有显著差异.
结论:
- 在HPE之后长期使用PPI与高患病率人群的胃癌风险显著增加有关.
- 存在明显的剂量反应关系,表明更高的PPI剂量会增加GC风险.
- 虽然GC风险增加,但PPI使用在本研究中没有显著影响GC相关的死亡率.
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