质子抑制剂的使用和中风风险:系统性审查和元分析
1Yaoyao Feng Department of Neurology, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, Zhejiang Province 313000, P.R. China.
Pakistan journal of medical sciences
|November 18, 2024
概括
质子抑制剂 (PPI) 的使用可能会增加缺血性中风的风险,特别是在65岁以下和所有性别的人群中. 某些PPI,如潘托普拉,显示出更高的风险,尽管总体发现由于研究异质性而不是统计学上显著.
科学领域:
- 临床医学 临床医学
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 质子抑制剂 (PPI) 广泛用于与酸有关的胃肠道疾病.
- 观察性研究表明,PPI使用与中风风险增加之间存在潜在联系.
- 需要进一步调查以澄清这种关联.
研究的目的:
- 调查使用质子抑制剂 (PPI) 与中风风险之间的关联.
- 分析现有的观察性研究,以确定PPI和中风发病率之间的潜在联系.
主要方法:
- 在PubMed,EMBASE和Cochrane CENTRAL进行了全面的文献搜索.
- 包括12项观察性研究,由两名审查员进行数据提取和质量评估.
- 使用随机效应模型计算了聚合危险比率 (HRs),并进行了子组分析.
主要成果:
- 对12项研究的总体分析 (I2=95%异质) 没有显示PPI使用与缺血性中风 (HR:1.11) 之间存在显著的关联.
- 亚组分析表明,在65岁以下的个人 (HR: 1.25),男性 (HR: 1.12) 和女性 (HR: 1.21) 中,PPI使用和缺血性中风风险之间存在相关性.
- 潘托普拉使用与高风险相关 (HR:1.66),而随访时间和PSM并没有改变这种关联.
结论:
- 使用PPI可能与缺血性中风的风险增加有关,特别是在年轻人 (<65岁) 和两性之间.
- 使用的PPI类型,如潘托普拉,可能会影响这种风险.
- 尽管发现了子组,但累积分析没有产生统计学上显著的结果,突出了所包含的研究中的大量异质性.
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