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JAMA Pediatr:警惕质子泵抑制剂导致儿童骨折风险

2020-03-23 MedSci原创 MedSci原创

质子泵抑制剂导致儿童骨折风险增加,在权衡质子泵抑制剂儿童治疗的益处和风险时,应考虑骨折风险

质子泵抑制剂(PPI)增加成人骨折风险,近日研究人员就儿童PPI使用与骨折风险的关系进行了考察。
 
研究人员分析了瑞典2006-16年间数据,比较18岁以下PPI患儿与非PPI患儿的骨折风险。采用Cox回归法对任何类型和5种骨折亚型的首次骨折危险比(HRs)进行估计,随访5年。
 
研究包括115933对儿童。在平均2.2年随访期间,PPI患儿发生5354例骨折,而非PPI患儿发生4568例骨折,每1000人-年发生骨折20.2次和18.3次(HR:1.11)。使用PPIs与上肢骨折(HR:1.08)、下肢骨折(HR:1.19)和其他骨折(HR:1.51)的风险增加有关,但与头部骨折(HR:0.93)或脊柱骨折(HR:1.31)无关。根据PPI使用的累积时间, 30天或30天以下的骨折HRs为1.08,31-364天为1.14,365天或以上为1.34。
 
研究认为,质子泵抑制剂导致儿童骨折风险增加,在权衡质子泵抑制剂儿童治疗的益处和风险时,应考虑骨折风险。
 
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    2020-04-06 jklm09
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    2020-09-20 feather89
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1852306, encodeId=4e2218523066c, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Mon Apr 06 11:40:11 CST 2020, time=2020-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728365, encodeId=17541e283657b, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Sun Sep 20 05:40:11 CST 2020, time=2020-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1639406, encodeId=5359163940683, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Jan 02 12:40:11 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667367, encodeId=0d40166e367bf, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Tue Jul 07 02:40:11 CST 2020, time=2020-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937344, encodeId=bd28193e34413, content=<a href='/topic/show?id=e20528531c9' target=_blank style='color:#2F92EE;'>#儿童骨折#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28531, encryptionId=e20528531c9, topicName=儿童骨折)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=09a12500213, createdName=12498f1em08(暂无昵称), createdTime=Thu Jan 14 17:40:11 CST 2021, time=2021-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1390420, encodeId=08a4139042052, content=<a href='/topic/show?id=22c6101695c9' target=_blank style='color:#2F92EE;'>#骨折风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101695, encryptionId=22c6101695c9, topicName=骨折风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Wed Mar 25 10:40:11 CST 2020, time=2020-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035981, encodeId=857510359811b, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Mar 23 22:40:11 CST 2020, time=2020-03-23, status=1, ipAttribution=)]
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1852306, encodeId=4e2218523066c, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Mon Apr 06 11:40:11 CST 2020, time=2020-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728365, encodeId=17541e283657b, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Sun Sep 20 05:40:11 CST 2020, time=2020-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1639406, encodeId=5359163940683, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Jan 02 12:40:11 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667367, encodeId=0d40166e367bf, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Tue Jul 07 02:40:11 CST 2020, time=2020-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937344, encodeId=bd28193e34413, content=<a href='/topic/show?id=e20528531c9' target=_blank style='color:#2F92EE;'>#儿童骨折#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28531, encryptionId=e20528531c9, topicName=儿童骨折)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=09a12500213, createdName=12498f1em08(暂无昵称), createdTime=Thu Jan 14 17:40:11 CST 2021, time=2021-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1390420, encodeId=08a4139042052, content=<a href='/topic/show?id=22c6101695c9' target=_blank style='color:#2F92EE;'>#骨折风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101695, encryptionId=22c6101695c9, topicName=骨折风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Wed Mar 25 10:40:11 CST 2020, time=2020-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035981, encodeId=857510359811b, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Mar 23 22:40:11 CST 2020, time=2020-03-23, status=1, ipAttribution=)]
    2020-03-23 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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患者坠床致尺桡骨骨折,保证患者安全,学学这种方法~

跌倒/坠床真的离我们不远,作为对患者伤害极大的一不良事件,严重影响护理安全。患者坠床原因有哪些?如何预防?

Eur Heart J:接受不同口服抗凝药治疗的房颤患者骨折风险

由此可见,与华法林相比,NOAC与AF患者的骨折风险降低有关。因此,如果需要口服抗凝药,则应考虑使用NOAC而非华法林来降低骨折的风险。但是,需要进一步的研究来调查潜在的机制并阐明因果关系。

肘关节前脱位合并尺骨鹰嘴及冠状突骨折1例

肘关节脱位在儿童并不多见,总发病率约3%,多数为后脱位,前脱位极为罕见,且多并发骨折。普通平片可明显观察到关节脱位,CT则有助于发现骨折,尤其是碎骨块嵌顿于关节内影响肘关节复位时。近期本院成功治疗一例肘关节前脱位患儿,报道如下。

甲状旁腺功能亢进致股骨颈骨折一例

患者,女,64岁,首诊以“左侧髋关节疼痛不适伴活动受限20天”入院。患者2个月前轻微扭伤出现右侧髋关节疼痛不适,20天前出现左侧髋关节疼痛不适伴活动明显受限,疼痛剧烈,无法站立行走。无下肢放射性疼痛,无晨僵、低热盗汗、胸闷憋气等表现。入院后,根据查体及影像学所见初步诊断为:双侧股骨颈骨折。患者既往无高血压、糖尿病及心脑血管疾病病史,否认家族中有遗传倾向性疾病及传染性疾病。

BMJ:孕期吸烟与后代骨折风险

研究发现,母亲孕期吸烟导致后代1岁前骨折风险增加

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