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Stroke:接受选择性血清素再摄取抑制剂治疗的卒中患者骨折风险如何?

2021-06-27 MedSci原创 MedSci原创

根据氟西汀和西酞普兰的现有RCT,使用6个月的SSRI使卒中幸存者的骨折风险增加了一倍。

卒中幸存者患抑郁症和骨折的风险增加。观察性研究结果表明选择性5-羟色胺再摄取抑制剂(SSRIs)与骨折风险增加相关。最近发表了几项报道SSRIs对卒中幸存者骨折风险影响的随机对照试验(RCT),但尚未进行荟萃分析。

近日,血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在明确卒中幸存者与SSRIs使用相关的骨折风险,以及跌倒、癫痫和复发性卒中的风险。


研究人员根据PROSPERO(CRD42020192632)中注册的方案,对卒中幸存者中评估SSRIs效果的RCT进行了系统回顾和荟萃分析。研究人员检索了WebofScience、EMBASE、PsycINFO和OvidMedline/PubMed数据库、临床试验等级中心和灰色文献,确定了比较SSRIs与安慰剂或无干预且报告了出血性或缺血性卒中成年幸存者骨折风险的RCT。两名研究人员独立筛选检索结果并提取数据。研究人员使用Mantel-Haenszel随机效应模型对每个结局进行荟萃分析。

SSRI相关的骨折风险比

 
研究人员共检索获得了683条记录,其中4项持续时间为6个月的RCT,共有6549名参与者被纳入荟萃分析:3项氟西汀研究和1项西酞普兰的研究。与安慰剂相比,使用SSRI治疗6个月会增加骨折风险,风险比为2.36(95%CI为1.64-3.39)。跌倒、癫痫发作和卒中复发的风险在统计学上没有显著增加。只有氟西汀和西酞普兰的研究可纳入该评价,因此研究结果对其他SSRI的普遍性尚存在不确定性。
 
由此可见,根据氟西汀和西酞普兰的现有RCT,使用6个月的SSRI使卒中幸存者的骨折风险增加了一倍。

原始出处:

Joshua S. Jones.et al.Risk of Fractures in Stroke Patients Treated With a Selective Serotonin Reuptake Inhibitor A Systematic Review and Meta-Analysis.stroke.2021.https://doi.org/10.1161/STROKEAHA.120.030558

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    2022-02-15 jklm09
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    2021-06-29 医鸣惊人

    认真学习了

    0

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    2021-06-28 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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