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Neurology:β2AR激动剂/拮抗剂与帕金森病的相关性

2019-05-29 QQ MedSci原创

目的:验证既往报道的长期使用β2-肾上腺素(β2AR)受体激动剂和拮抗剂与帕金森病(PD)的风险降低和增加之间的相关性。方法:从丹麦国家卫生系统中评估β2AR激动剂和拮抗剂与PD风险的优势比(ORs)关联时间。结果:共纳入2790位PD患者和11160位对照。长期采用β2AR激动剂与PD风险降低相关(OR 0.57,95% CI 0.40-0.82)。出乎意料的是,短期应用β2AR激动剂也有类似的

目的:验证既往报道的长期使用β2-肾上腺素(β2AR)受体激动剂和拮抗剂与帕金森病(PD)的风险降低和增加之间的相关性。

方法:从丹麦国家卫生系统中评估β2AR激动剂和拮抗剂与PD风险的优势比(ORs)关联时间。

结果:共纳入2790位PD患者和11160位对照。长期采用β2AR激动剂与PD风险降低相关(OR 0.57,95% CI 0.40-0.82)。出乎意料的是,短期应用β2AR激动剂也有类似的相关性(OR 0.64,95% CI 0.42-0.98)。鉴于β2AR激动剂主要是用于治疗慢性阻塞性肺疾病(COPD),而COPD往往是由长期吸烟造成的,因此,研究人员还分析了吸烟的其他标志物。

确诊COPD(OR 0.51,95% CI 0.37-0.69)和采用吸入性皮质类固醇(OR 0.78,95% CI 0.59-1.02)或吸入性抗胆碱能药物(OR 0.41,95% CI 0.25-0.67)也均与PD负相关。此外,并不是所有β2AR拮抗剂都会增加PD风险,仅普萘洛尔和美托洛尔会增加PD风险,而且短期应用的相关性明显强于长期应用的相关性。

总结:本研究表明应用β2AR激动剂与PD风险降低相关,而β2AR拮抗剂与PD风险增加相关。但本研究提示β2AR激动剂与PD风险的相关性受吸烟间接影响;吸烟与PD风险降低相关。β2AR拮抗剂与PD风险的相关性显示为反向因果关系,即PD症状促进予以β2AR拮抗剂治疗,而不是β2AR拮抗剂导致PD。总而言之,目前的流行病学数据尚不足以支持β2AR激动剂和拮抗剂与PD风险之间的因果关系。

原始出处:

Franziska Hopfner, et al. Use of β2-adrenoreceptor agonist and antagonist drugs and risk of Parkinson disease. Neurology. May 24, 2019. DOI: https://doi.org/10.1212/WNL.0000000000007694

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