在患有慢性病的患者中使用质子抑制剂和骨折
Andreas Kommer1, Karel Kostev2, Eva Maria Schleicher1
1Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
概括
质子抑制剂 (PPI) 的使用增加了慢性病 (CKD) 患者的骨折风险. 在没有明确迹象的CKD患者中减少PPI的使用可能会降低骨折发生率.
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.
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 患有慢性病 (CKD) 的患者面临骨折的高风险,导致显著的发病率和死亡率.
- 以前的研究表明,在一般人群和血液透析患者中,质子抑制剂 (PPI) 使用和骨折之间存在联系,但对CKD患者的数据缺乏.
研究的目的:
- 研究使用质子抑制剂 (PPI) 与慢性病 (CKD) 患者骨折风险之间的关联.
主要方法:
- 使用IQVIA疾病分析数据库进行了基于人口的观察病例控制研究.
- 患有CKD和骨折的患者与没有骨折的对照人群进行1:1匹配,使用倾向性得分匹配.
- 进行了多变量逻辑回归分析,以评估PPI使用和骨折之间的关联,并对混因素进行调整.
主要成果:
- 该研究包括6076名骨折患者和6076名没有骨折的匹配对照.
- 质子抑制剂 (PPI) 的使用与慢性病患者骨折风险增加显著相关 (OR 1.68;95% CI 1.55-1.83).
- 最强的相关性是在60岁以下的患者长期使用PPI (>2年) 或高累积PPI剂量中观察到的,没有性别差异.
结论:
- 质子抑制剂 (PPI) 的使用与患有慢性病 (CKD) 的患者骨折风险增加有关.
- 在缺乏有效指示的CKD患者中停止处方质子抑制剂 (PPI) 是一种潜在的可修改策略,以减轻这种脆弱人群的骨折风险.
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