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Rheumatology (Oxford):长期羟氯喹能保护SLE患者血管吗?

2017-12-26 吴星 环球医学

2017年12月,发表在《Rheumatology (Oxford)》的一项由台湾科学家进行的数据库前瞻性队列研究,考察了长期羟氯喹(HCQ)对系统性红斑狼疮(SLE)患者血管事件的影响。

2017年12月,发表在《Rheumatology (Oxford)》的一项由台湾科学家进行的数据库前瞻性队列研究,考察了长期羟氯喹(HCQ)对系统性红斑狼疮(SLE)患者血管事件的影响。

目的:SLE患者的血栓栓塞发病率高于普通人群。广泛用于治疗狼疮的HCQ或有血管保护作用。本研究的目的是确定长期HCQ暴露是否与SLE患者血栓栓塞风险降低相关。

方法:研究者基于台湾地区健康保险研究数据库,设计了一项针对SLE人群的前瞻性队列研究。根据第一年HCQ的处方情况,研究者将受试者分为HCQ组和对照组。这两个组分别以药物持有率(MPR)≥80%和MPR=0%来定义。排除MPR在0至80%的患者。主要结局为包括入组后1年急性冠脉综合征、缺血性卒中、肺栓塞、深静脉血栓以及外周动脉病变在内的复合心血管事件。第一年内出现结局的患者被排除在队列之外。

结论:共8397例患者符合分析条件。倾向评分匹配后,每组纳入1946例患者。在平均7.4年的随访期中,HCQ组的事件数量为139(7.1%),对照组为149(7.7%)。HCQ组的血管事件风险与对照组相似(风险比=0.91;95% 置信区间[CI]:0.72~1.15)。进一步的亚组研究分析证明,组间无统计学显着差异。

结论:长期HCQ似乎对SLE患者没有血管保护作用。

原始出处:

Hsu CY, Lin YS, Su YJ, et al. Effect of long-term hydroxychloroquine on vascular events in patients with systemic lupus erythematosus: a database prospective cohort study. Rheumatology (Oxford). 2017 Dec 1;56(12):2212-2221. doi: 10.1093/rheumatology/kex357.

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