质子抑制剂的使用和恶化功能:一项回顾性队列研究,包括122,606名抑制酸的用户
Antonio González-Pérez1,2, Samuel J Martínez-Domínguez3,4,5, Ángel Lanas6,7,8,9
1Centro Español de Investigación Farmacoepidemiológica (CEIFE), Spanish Centre for Pharmacoepidemiologic Research, Madrid, Spain. agonzalez@ceife.es.
Journal of general internal medicine
|December 3, 2024
概括
与H2阻塞剂相比,使用质子抑制剂 (PPI) 在恶化功能方面没有显著差异. 然而,PPI发起者患急性损伤 (AKI) 的风险较低.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 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) 使用与功能下降之间的关联仍然存在争议,缺乏明确的病理生理学证据.
- 现有研究提出了关于PPI脏安全性的相互矛盾的发现.
研究的目的:
- 评估 PPI 与 H2 阻断剂相比,在开始 PPI 的患者中恶化功能和急性损伤 (AKI) 的风险.
- 为了比较这两个药物类别之间的不良脏事件的发生率.
主要方法:
- 一项回顾性队列研究利用了来自西班牙阿拉贡的BIGAN健康数据库的纵向数据.
- 从2015年到2021年,对119,520名PPI发起者和3,086名H2-阻断剂发起者进行了随访,这些发起者保持了功能.
- 恶化功能和AKI是主要终点,使用发病率和考克斯回归来分析调整后的危险比率 (HR).
主要成果:
- 虽然拉尼蒂丁 (一种H2阻断剂) 治疗功能恶化的原始发病率低于PPI,但调整后的考克斯回归没有显示出显著差异 (HR 0.99).
- 与ranitidine发起者 (HR 0.54) 相比,PPI发起者表现出明显较低的急性损伤 (AKI) 发病率和风险.
结论:
- 在PPI和H2-阻断剂发起者之间,没有发现对功能恶化的临床显著差异.
- 与拉尼蒂丁开始使用相比,使用PPI与急性损伤 (AKI) 的风险降低有关.
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