质子抑制剂和慢性病风险:与基因素-2受体对抗剂进行比较研究
Takhyeon Kweon1, Yerim Kim1, Kyung Joo Lee1
1Department of Internal Medicine, College of Medicine, Kangdong Sacred Heart Hospital, Hallym University, 150, Seongan-to, Guangdong-Gu, Seoul, 05355, Korea.
Scientific reports
|November 30, 2023
概括
质子抑制剂 (PPI) 和组胺-2-受体对抗剂 (H2RA) 的使用显示了慢性病 (CKD) 的类似风险. 需要进一步研究潜在的PPI诱导的CKD,影响长期处方决策.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 质子抑制剂 (PPI) 和组胺-2-受体对抗剂 (H2RA) 常用于减少胃酸.
- 人们担心PPI的潜在毒作用,导致慢性病 (CKD) 的风险增加.
研究的目的:
- 调查PPI和H2RA使用与随后患CKD的风险之间的关联.
- 为了比较使用PPI与H2RAs的患者中CKD的发病率.
主要方法:
- 使用两个大型数据集的观察性研究:国家医疗保险服务-国家样本队列 (NHIS-NSC) 和六家医院的电子健康记录 (EHR) 数据库.
- 倾向性得分匹配用于平衡PPI和H2RA用户群之间的基线特征.
- 分析了CKD发病率,并在各组之间进行了比较,并对EHR数据进行了元分析.
主要成果:
- 在NHIS-NSC队列中,PPI和H2RA使用者之间的CKD发病率是可比的 (HR = 0.68;95% CI,0.35-1.30).
- 对EHR数据的分析表明,与PPI使用相比,与H2RA使用相比,CKD风险没有显著增加 (HR = 1.03;95%CI:0.87-1.23).
结论:
- 目前的证据表明,与H2RA使用相比,PPI使用可能不会增加CKD的风险.
- 潜在的PPI诱导的CKD需要进一步调查,特别是对于长期治疗的患者.
- 临床医生在做出长期抑制酸性药物的处方决定时应考虑这些发现.
相关概念视频
Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists
487
Histamine H2 receptors, which are intricately located on the basolateral membrane of parietal cells, play a crucial role in modulating gastric acid secretion. When released from enterochromaffin-like cells, histamine engages H2 receptors, initiating the cyclic AMP (cAMP) pathway. In this pathway, adenylyl cyclase converts ATP into cAMP, elevating intracellular cAMP levels. The activation of protein kinase A follows, stimulating the proton pump. This stimulation prompts the secretion of hydrogen...
487
Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
435
Peptic ulcers, often induced by H. pylori infections or NSAID usage, arise from disruptions in the delicate balance of gastric acid production. Peptic ulcers stem from heightened gastric acid levels due to H. pylori infections or NSAID use. The protective mucus layer diminishes in the presence of these factors, allowing gastric acid to erode the stomach lining and form ulcers.
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
435
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
436
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
436
Antihypertensive Drugs: Potassium-Sparing Diuretics
582
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
582
Pathophysiology of Peptic Ulcer Disease: Injurious Factors
597
Peptic ulcers are sores on the stomach's inner lining and the upper small intestine, which are the result of disruptions in the mucosal layer that houses parietal cells which produce gastric acid, and chief cells which secrete pepsinogen.
In the antrum region, G cells secrete the gastrin hormone that binds to gastrin-cholecystokinin-B (CCK2) receptors on parietal and enterochromaffin-like (ECL) cells in the fundic glands. Simultaneously, the vagus nerve releases acetylcholine, which binds...
In the antrum region, G cells secrete the gastrin hormone that binds to gastrin-cholecystokinin-B (CCK2) receptors on parietal and enterochromaffin-like (ECL) cells in the fundic glands. Simultaneously, the vagus nerve releases acetylcholine, which binds...
597
Antihypertensive Drugs: Direct Renin Inhibitors
637
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
637


