在患有慢性阻塞性肺病的患者中,zolpidem的风险
Jason M Castaneda1,2, Travis Hee Wai3, Laura J Spece1,2
1Division of Pulmonary, Critical Care, and Sleep Medicine, The University of Washington, Seattle, Washington.
Annals of the American Thoracic Society
|November 2, 2023
概括
对于患有慢性阻塞性肺病 (COPD) 的患者来说,与其他催眠药相比,皮 (一种非二胺催眠药) 没有增加死亡或恶化的风险. 然而,与没有催眠使用相比,佐尔皮与更高的风险有关.
科学领域:
- 肺部医学 肺部医学
- 药理学 药理学是指药理学的学科.
- 临床研究 临床研究
背景情况:
- 非二胺类二胺受体激应剂 (NBZRAs),如二,是COPD患者常见的失眠治疗方法.
- 观察性研究表明,NBZRAs增加了COPD的死亡率和呼吸风险,但缺乏活跃的比较剂,有可能因指示而引起混.
研究的目的:
- 为了比较Zolpidem与其他催眠药在COPD患者中死亡或住院COPD恶化的风险.
- 为了评估与皮相关的风险,与在COPD患者中没有催眠使用相比.
主要方法:
- 利用全国退伍军人健康管理局的COPD患者的数据,这些患者接受了新的索尔皮或替代性催眠药 (美拉,特拉佐,多克西) 处方.
- 在32个变量上使用倾向匹配来比较皮使用者与其他催眠药使用者和非使用者.
- 在1年的时间内评估了死亡或住院COPD恶化的综合结果.
主要成果:
- 在1:1倾向匹配的比较中,使用佐尔皮并没有显著增加死亡风险或住院COPD恶化的风险与其他催眠药相比 (HR,0.97;95% CI,0.77-1.23).
- 与匹配的非使用者相比,皮的使用与复合结果的风险更高有关 (HR,1.40;95% CI,1.09-1.81).
结论:
- 与替代催眠药相比,在COPD患者中使用zolpidem并没有增加风险.
- 在将佐洛皮与没有催眠药的使用进行比较时观察到的风险增加可能源于各种类别的催眠药的未测量的混或真正的不良影响.
- 需要进一步的研究来阐明COPD患者中催眠药的风险.
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