慢性阿片类药物暴露与心血管疾病之间的关联:系统性审查和元分析
Joe Schofield1, Aldo Alberto Conti2, Faisel Khan3
1School of Medicine, University of St Andrews, North Haugh, St Andrews, Scotland, KY16 9TF.
European journal of preventive cardiology
|August 12, 2025
概括
慢性阿片类药物暴露 (COE) 显著增加心血管疾病 (CVD) 的风险,特别是中风和心脏病. 需要进一步的研究来了解机制和潜在的干预措施.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 慢性阿片类药物暴露 (COE) 很普遍,但其与心血管疾病 (CVD) 的联系需要澄清.
- 了解与各种形式的阿片类药物使用相关的CVD风险对于公共卫生至关重要.
研究的目的:
- 系统地审查和元分析有关COE和心血管疾病风险之间的关联现有证据.
- 调查不同类型的阿片类药物使用的风险,包括处方阿片类药物,片和阿片类药物使用障碍 (OUD).
主要方法:
- 一个系统的审查和元分析,遵循PRISMA指南.
- 包括报告COE和CVD关联的人类研究,随机效应元分析.
- 小组分析,元回归和偏差风险评估 (ROBINS-E).
主要成果:
- 包括17项研究 (1,676,000名参与者);13项研究对分析做出了贡献.
- 对于心血管疾病风险增加,COE显示了1.74 (95% CI: 1.12-2.70) 的合并几率比率 (OR).
- 在脑血管事故 (OR: 1.84) 和缺血性心脏病 (OR: 1.51) 中发现的最强的关联;片使用显示出显著的心血管疾病关联.
结论:
- COE与患心血管疾病,特别是脑血管事故和缺血性心脏病的风险更高有关.
- 由于阿片类药物使用和心血管疾病的全球负担,有针对性的干预和综合护理是必要的.
- 进一步的研究应侧重于机制,因果关系,剂量反应和风险的可逆性.
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