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CMAJ:警示!苯二氮䓬类药物或增加阿尔兹海默病患者肺炎风险

2017-04-24 何娜;常路 环球医学

2017年4月,发表在《CMAJ》的一项研究表明,苯二氮?类药物的使用与阿尔兹海默病患者肺炎风险的增加相关。当权衡该群体苯二氮卓类药物的风险和获益时,应予以考虑肺炎的风险。背景:苯二氮卓类药物和相似作用的非苯二氮卓类药物(Z药物)是否与老年人肺炎风险的增加相关是未知的。研究人员在社区管理的阿尔兹海默病成年患者中调查了该相关性,这些患者常使用镇静/催眠类药物,并且易发肺炎。方法:芬兰药物使用和阿尔兹



2017年4月,发表在《CMAJ》的一项研究表明,苯二氮类药物的使用与阿尔兹海默病患者肺炎风险的增加相关。当权衡该群体苯二氮卓类药物的风险和获益时,应予以考虑肺炎的风险。

背景:苯二氮卓类药物和相似作用的非苯二氮卓类药物(Z药物)是否与老年人肺炎风险的增加相关是未知的。研究人员在社区管理的阿尔兹海默病成年患者中调查了该相关性,这些患者常使用镇静/催眠类药物,并且易发肺炎。

方法:芬兰药物使用和阿尔兹海默病队列(MEDALZ)纳入了处方、报销、出院和死因的全国注册数据。研究人员从该队列中获取了近期诊断为阿尔兹海默病(2005~2011)的所有社区管理的成年患者的数据。使用1年的清除期鉴别出苯二氮卓类药物和Z药物的使用者,使用倾向得分与不使用者配对。与肺炎造成的入院或死亡的相关性使用Cox比例风险模型进行分析,并以时间依赖的方式调整了其他精神类药物的使用。

结果:49484名符合条件的阿尔兹海默病患者中,5232人服用苯二氮卓类药物,3269人使用非苯二氮卓类药物,并与不使用这些药物的对照进行了1:1的配对。总的来说,苯二氮卓类药物和非苯二氮卓类药物的使用与肺炎风险的增加相关(调整风险比HR,1.22;95% CI,1.05~1.42)。单独分析时,苯二氮卓类药物的使用与肺炎风险的增加显着相关(调整HR,1.28;95% CI,1.07~1.54),而非苯二氮卓类药物的使用并非如此(调整HR,1.10;95% CI,0.84~1.44)。苯二氮卓类药物使用的首个30天内,肺炎风险最高(HR,2.09;95% CI,1.26~3.48)。

结论:苯二氮卓类药物的使用与阿尔兹海默病患者肺炎风险的增加相关。当权衡该群体苯二氮卓类药物的风险和获益时,应该予以考虑肺炎的风险。

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    2017-06-28 Johnson_zhangdr

    研究方法,值得学习。

    0

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