抗抑郁药使用与静脉血栓栓塞的风险之间的关联:系统性审查和元分析
Minyoung Uh1, Hey Young Rhee2, Kiyon Rhew1
1College of Pharmacy, Dongduk Women's University, Seoul 02748, Republic of Korea.
Journal of clinical medicine
|August 14, 2025
概括
抗抑郁药的使用与静脉血栓栓塞 (VTE) 的更高风险有关,这是一个血栓状况. 这种风险在最近使用抗抑郁药物和特定类型的静脉瘤,包括肺栓塞 (PE) 时更加明显.
科学领域:
- 药物监督 药物监督 药物监督
- 心血管流行病学心血管流行病学
- 临床药理学 临床药理学
背景情况:
- 抗抑郁药被广泛处方,需要了解其潜在的不良影响.
- 静脉血栓塞栓症 (VTE),包括深静脉血栓和肺栓塞 (PE),是严重的公共卫生问题.
研究的目的:
- 系统地审查和元分析观察性研究,评估抗抑郁药使用与静脉瘤风险之间的关联.
- 量化与抗抑郁药物治疗相关的静脉瘤风险.
主要方法:
- 在主要数据库 (Medline,Embase,Web of Science) 进行了全面的文献搜索,截至2024年12月.
- 包括18项观察性研究 (队列,病例控制),使用纽卡斯尔-太华规模评估质量.
- 汇集的相对风险 (RR) 用随机效应模型计算,并对近期,VTE类型和亚型进行子组分析.
主要成果:
- 抗抑郁药的使用与静脉瘤风险的统计显著增加有关 (RR = 1.22;95% CI: 1.12-1.32).
- 最近使用抗抑郁药 (90天内),首次发病的VTE,复发的VTE和PE观察到更强的关联.
- 敏感性分析证实了研究结果的稳定性,并没有发现出版偏差.
结论:
- 这一元分析表明,与抗抑郁药物使用相关的VTE风险略微但显著增加.
- 风险增加在最近的使用者,首次或复发性VTE以及PE中尤其明显.
- 在处方抗抑郁药时,临床医生应考虑个性化VTE风险评估.
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