阿尔法-1上腺受体对手使用与认知障碍之间的关联:系统性审查
Ryan Kingsley1, Sara Tyree1, Dhairya Jarsania1
1Division of Hospital Medicine, Mayo Clinic, Rochester, MN, USA.
International neurourology journal
|October 4, 2024
概括
用于BPH和高血压的α-1上腺素受体 (α1-AR) 抗剂与认知功能障碍没有令人信服的联系. 临床医生可以在不担心认知副作用的情况下处方这些药物,等待进一步的研究.
科学领域:
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
- 老年学是一门学科.
背景情况:
- 阿尔法-1上腺素受体 (α1-AR) 抗剂被广泛用于良性前列腺增生和高血压.
- 关于使用α1-AR抗剂与认知障碍之间的关联,存在相互矛盾的证据.
研究的目的:
- 系统地审查α1-AR抗剂使用与认知功能障碍之间的关联.
- 为临床医生提供基于证据的指导,关于药物治疗的开始和持续.
主要方法:
- 在遵守PRISMA指南的基础上进行系统审查.
- 搜索了多个数据库 (Ovid Cochrane,Embase,MEDLINE,Scopus,Web of Science) 更新时间为2024年1月.
- 评估研究质量使用RCT的Cochrane偏差风险和非RCT的MINORS.
主要成果:
- 包括7项研究 (3项RCT,4项非RCT);坦素是最受研究的.
- 坦苏洛辛的结果是混合的:没有认知功能障碍 (2 RCT),痴呆风险增加 (2 非RCT),没有变化 (1 非RCT),痴呆风险降低 (1 非RCT).
- 阿尔福佐辛显示出混合的结果;多克萨佐辛,普拉佐辛和特拉佐辛是中性的或显示出痴呆风险降低.
结论:
- 这一系统性审查没有发现α1-AR抗剂与认知功能障碍之间的有说服力的因果关系.
- 目前的证据表明α1-AR对抗剂可以在不担心认知副作用的情况下使用.
- 需要进一步的强有力的研究来充分阐明这种关系,考虑到认知功能障碍的多因素性质.
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