预计膜过率的变化在接受质子抑制剂的患者中:单中心队列研究
Takuma Murofushi1,2, Tatsuya Yagi3, Daiki Tsuji1
1Department of Clinical Pharmacology and Genetics, University of Shizuoka, Shizuoka, Japan.
Naunyn-Schmiedeberg's archives of pharmacology
|January 3, 2024
概括
质子抑制剂 (PPI) 的使用可能会加快功能衰退,特别是在基线EGFR较高或年龄较小的患者中. 这项研究强调了与H2RAs相比,与长期使用PPI相关的潜在脏风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 质子抑制剂 (PPI) 广泛用于与酸有关的胃肠道疾病.
- 已经提出了PPI使用和功能障碍之间的潜在关联.
- 使用估计的膜过率 (eGFR) 斜率评估功能下降对于理解长期影响至关重要.
研究的目的:
- 调查使用质子抑制剂 (PPI) 与功能障碍之间的关联.
- 评估PPI对估计的膜过率 (eGFR) 斜率的影响.
- 为了比较PPI与历史胺H2受体对抗剂 (H2RAs) 的效应.
主要方法:
- 一个单一中心的队列研究,利用2010-2021年的健康记录.
- 纳入标准:首次使用PPI或H2RA的患者,持续处方≥90天.
- 倾向性得分匹配 (PSM) 用于将PPI用户与H2RA用户进行比较;使用线性混合效应模型估计了eGFR斜率.
主要成果:
- 该研究包括4,649名参与者 (3,699名PPI用户,950名H2RA用户),每组PSM后911人.
- 对于PPI用户来说,eGFR的斜率为-4.75/年,对于H2RA用户来说是-3.40/年,整体上没有显著差异.
- 在基线eGFR≥90mL/min/1.73m2或年龄<65岁的PPI使用者中观察到显著的eGFR下降.
结论:
- 长期使用PPI (≥90天) 可能与H2RA使用相比,功能下降的速度更快.
- 这种效应在基线eGFR较高或年龄较小的患者中显得更加明显.
- 需要进一步的研究来阐明与PPI相关的功能变化的机制和临床影响.
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