质子抑制剂使用与痴呆风险之间的关联不一致:更新的元分析

Tzu-Rong Peng^1,2,3, Hung-Hong Lin⁴, Li-Jou Yang¹

¹Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan.

Brain sciences

|February 27, 2026

概括

质子抑制剂 (PPI) 的使用并不总是与整体痴呆风险相关. 然而,一些子组,如老年人和某些地区,显示风险较高,需要谨慎处方.

科学领域:

神经科学是一个神经科学.
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) 广泛用于胃肠道疾病.
人们对PPE的长期安全性存在担忧,特别是它们与痴呆症和阿尔茨海默病 (AD) 的潜在关联.
之前关于PPI和痴呆风险的研究产生了相互矛盾的结果.

研究的目的:

系统地评估使用质子抑制剂 (PPI) 与患痴呆症的风险之间的关联.
提供对现有证据的全面和最新评估.

主要方法:

在主要数据库 (PubMed,Embase,Cochrane图书馆) 进行了系统的文献搜索,直到2025年5月.
包括调查PPI与痴呆症相关性的观察性研究,数据被提取并由两名独立研究人员评估质量.
使用随机效应模型进行定量合成,计算聚合风险比率 (RRs) 和置信区间.

主要成果:

分析了18项涉及超过630万参与者的研究.
在PPI使用和痴呆风险之间没有发现统计学上显著的总体关联 (RR = 1.14,95% CI 0.98-1.33).
发现了显著的异质性和偏差风险. 亚组分析表明,65岁以上的个体以及亚洲和欧洲的研究中风险增加.

结论:

目前的证据不一致支持PPI使用与整体痴呆风险之间的联系,主要是由于研究异质性.
特定子组 (老年人,某些地区) 的高风险表明潜在的脆弱性,但不证实因果关系.
强调适当的PPI处方管理至关重要,将长期使用保留给合理的情况和最短的有效持续时间.

关键词:

阿尔茨海默氏症是阿尔茨海默氏症的一种疾病.认知能力下降认知能力下降痴呆症痴呆症是一种痴呆症.这是一个元分析.观察性研究是指观察性研究.质子抑制剂的使用

相关概念视频

01:15

Drug Dosing: Geriatric Patients

327

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...

327

01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

284

01:13

Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors

1.0K

Peptic ulcers, often induced by H. pylori infections or NSAID usage, arise from disruptions in the delicate balance of gastric acid production. Peptic ulcers stem from heightened gastric acid levels due to H. pylori infections or NSAID use. The protective mucus layer diminishes in the presence of these factors, allowing gastric acid to erode the stomach lining and form ulcers.
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...

1.0K

01:23

Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance

780

The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...

780

01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

273

Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...

273

01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

299

Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...

299