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Aliment Pharmacol Ther:低剂量阿司匹林使用者下消化道出血风险知多少

2017-06-20 应颖秋 环球医学资讯

2017年6月,发表在《Aliment Pharmacol Ther》的一项由台湾科学家进行的研究,考察了低剂量阿司匹林使用者下消化道出血(LGIB)的风险。

2017年6月,发表在《Aliment Pharmacol Ther》的一项由台湾科学家进行的研究,考察了低剂量阿司匹林使用者下消化道出血(LGIB)的风险。

背景:阿司匹林增加胃肠道出血风险。

目的:考察阿司匹林使用者LGIB的风险。

方法:从台湾健康保险研究数据库1百万例随机样本受试者中,筛选出低剂量(每天75~325 mg)阿司匹林使用者,和按照1:5的比例,通过年龄、性别和纳入时间匹配的对照。开发Cox比例风险回归模型,评估LGIB的预测因素,校正年龄、性别、包括冠状动脉疾病、缺血性组中、糖尿病高血压、慢性肾病、肝纤维化、慢性阻塞性肺病、血脂障碍、无并发症消化性溃疡、消化性溃疡出血史在内的并发症,以及氯吡格雷、噻氯匹定、华法林、非甾体类抗炎药(NSAIDs)、COX-2抑制剂、类固醇、质子泵抑制剂(PPIs)、组胺2受体拮抗剂(H2RAs)、硝酸盐、阿仑唑奈、选择性5-羟色胺再摄取抑制剂(SSRIs)和钙通道阻滞剂的联合使用。

结果:共纳入53805例阿司匹林使用者和269025例对照。阿司匹林组1年内LGIB的发病率高于对照组(0.20% vs 0.06%,P<0.0001)。阿司匹林(风险比[HR]:2.75,95%置信区间[CI]:2.06~3.65)、NSAIDs(HR:8.61,95% CI:3.28~22.58)、类固醇(HR:10.50,95% CI:1.98~55.57)、SSRIs(HR:11.71,95% CI:1.40~97.94)、PPIs(HR:8.47,95% CI:2.26~31.71)和H2RAs(HR:10.83,95% CI:2.98~39.33)与LGIB显着相关。

结论:在此队列中,低剂量阿司匹林使用者的LGIB风险高于不使用阿司匹林人群。低剂量阿司匹林、NSAIDs、类固醇、SSRIs、PPIs和H2RAs是LGIB的独立风险因素。

原始出处:
Chen, W. C., et al.The risk of lower gastrointestinal bleeding in low-dose aspirin users.Aliment Pharmacol Ther. 2017 Jun;45(12):1542-1550. doi: 10.1111/apt.14079. Epub 2017 Apr 27.

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    2017-11-07 jj000001
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    2017-08-27 yb6560
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  8. 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  9. 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time=2017-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213184, encodeId=0eee21318498, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Tue Jun 20 19:24:37 CST 2017, time=2017-06-20, status=1, ipAttribution=)]
    2017-06-20 清风拂面

    受益匪浅,谢谢分享

    0

  10. 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time=2017-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213184, encodeId=0eee21318498, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Tue Jun 20 19:24:37 CST 2017, time=2017-06-20, status=1, ipAttribution=)]
    2017-06-20 131****1460

    学习了受益匪浅。

    0

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近日,《女性健康》杂志上刊登了一篇标题为《低剂量的阿司匹林可以减少糖尿病女性患乳腺癌风险》的文章,这是一份来自台湾中山医学院的研究人员进行的一次回顾性研究结果报告。

神药阿司匹林:退烧、镇痛、预防心脏病,还可能阻止癌症扩散

撰文:薇薇安·卡列尔(Viviane Callier)翻译:贾明月如果世上真的存在神药,那一定是阿司匹林。这种最初从柳树皮中提取出的药物逐渐扬名立万,成为家庭药箱的中流砥柱。在好几辈人的手中,它成功地治疗了多种疾病,比如关节炎和发烧。有时人们会把它当作预防性的药物,防止卒中和心脏病发作,或者尝试用它预防特殊类型的癌症。这种药实在太受欢迎了,在全世界范围内,每年都会售出大约1200亿片的阿司匹林

“神药”阿司匹林的16个副作用,你了解吗?

阿司匹林在一般治疗剂量时,不良反应较少;大剂量(如抗风湿治疗)或长期服用时,则有一定的不良反应。

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