Am J Gastroenterol:长期使用质子泵抑制剂,不会增加骨折风险

2016-11-20 MedSci MedSci原创

多种研究表明质子泵抑制剂(PPI)和骨折之间存在联系。但是这种关联的因果关系是值得怀疑的,因为没有一个明确的作用机制,也没有通过使用双光子X线吸收法(DXA)证实质子泵抑制剂对面积骨密度(aBMD)存在某种作用的证据。 我们使用三维定量计算机断层扫描(3D-QCT)成像来确定长期使用PPI与骨结构变化之间的联系,独立于aBMD。 我们选取的样本均为长期服用PPI的患者,服药时间≥5年,

多种研究表明质子泵抑制剂(PPI)和骨折之间存在联系。但是这种关联的因果关系是值得怀疑的,因为没有一个明确的作用机制,也没有通过使用双光子X线吸收法(DXA)证实质子泵抑制剂对面积骨密度(aBMD)存在某种作用的证据。

我们使用三维定量计算机断层扫描(3D-QCT)成像来确定长期使用PPI与骨结构变化之间的联系,独立于aBMD。

我们选取的样本均为长期服用PPI的患者,服药时间≥5年,匹配在前5年没有使用PPI的类似队列。所有受试者均接受DXA评估aBMD、3D-QCT评估体积骨密度、以及骨代谢的标记物。测量骨强度,包括屈曲比和截面模量,同时进行组间比较。

研究纳入104例受试者,其中PPI使用者和非使用者各占52例。两组间的标准骨密度、体积骨密度、骨代谢标志物和骨强度指标均无显著性差异。

长期使用PPI不会导致骨密度和骨强度的变化,所以不会导致骨折风险的增加。这些发现提供了进一步的证据表明,使用PPI与骨折之间并没有因果关系。

原始出处:

Laura E Targownik.et al.Long-Term Proton Pump Inhibitor Use Is Not Associated With Changes in Bone Strength and Structure.Am J Gastroenterol advance online publication 15 November 2016

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    2017-02-21 许安
  4. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=41, 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=Wed Feb 22 04:29:00 CST 2017, time=2017-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1390359, encodeId=10e21390359f2, 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=28, 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=Tue Nov 22 13:29:00 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157404, encodeId=adc815e40460, content=学习了,哈哈, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRvvXNvY0kOJqn4liar3Q6V6yPuEIawCVUyP3jVADh5icIz0ibrsxia6fKAqKsDr33jPWrjqM3D7wcRNu/0, createdBy=5a881701729, createdName=小树熊, createdTime=Tue Nov 22 08:41:14 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
  5. 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createdName=ms24272190615788285182, createdTime=Wed Mar 08 17:29:00 CST 2017, time=2017-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071695, encodeId=8dea20e16950e, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Tue Feb 21 09:29:00 CST 2017, time=2017-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064030, encodeId=f8042064030f4, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/098A00A9C4C0773FE4ED3B5A7DDA571F/100, createdBy=28b41996166, createdName=华笙医学编译, createdTime=Fri Dec 16 14:07:47 CST 2016, time=2016-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=163294, encodeId=25be163294d5, content=文章不错,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Dec 16 14:04:14 CST 2016, time=2016-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667314, encodeId=6cf6166e314a8, 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=41, 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=Wed Feb 22 04:29:00 CST 2017, time=2017-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1390359, encodeId=10e21390359f2, 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=28, 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=Tue Nov 22 13:29:00 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157404, encodeId=adc815e40460, content=学习了,哈哈, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRvvXNvY0kOJqn4liar3Q6V6yPuEIawCVUyP3jVADh5icIz0ibrsxia6fKAqKsDr33jPWrjqM3D7wcRNu/0, createdBy=5a881701729, createdName=小树熊, createdTime=Tue Nov 22 08:41:14 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
    2017-08-24 jklm09
  6. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/098A00A9C4C0773FE4ED3B5A7DDA571F/100, createdBy=28b41996166, createdName=华笙医学编译, createdTime=Fri Dec 16 14:07:47 CST 2016, time=2016-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=163294, encodeId=25be163294d5, content=文章不错,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Dec 16 14:04:14 CST 2016, time=2016-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667314, encodeId=6cf6166e314a8, 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=41, 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=Wed Feb 22 04:29:00 CST 2017, time=2017-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1390359, encodeId=10e21390359f2, 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=28, 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=Tue Nov 22 13:29:00 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157404, encodeId=adc815e40460, content=学习了,哈哈, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRvvXNvY0kOJqn4liar3Q6V6yPuEIawCVUyP3jVADh5icIz0ibrsxia6fKAqKsDr33jPWrjqM3D7wcRNu/0, createdBy=5a881701729, createdName=小树熊, createdTime=Tue Nov 22 08:41:14 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
    2016-12-16 华笙医学编译

    支持下 都是知识啊

    0

  7. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/098A00A9C4C0773FE4ED3B5A7DDA571F/100, createdBy=28b41996166, createdName=华笙医学编译, createdTime=Fri Dec 16 14:07:47 CST 2016, time=2016-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=163294, encodeId=25be163294d5, content=文章不错,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Dec 16 14:04:14 CST 2016, time=2016-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667314, encodeId=6cf6166e314a8, 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=41, 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=Wed Feb 22 04:29:00 CST 2017, time=2017-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1390359, encodeId=10e21390359f2, 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=28, 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=Tue Nov 22 13:29:00 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157404, encodeId=adc815e40460, content=学习了,哈哈, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRvvXNvY0kOJqn4liar3Q6V6yPuEIawCVUyP3jVADh5icIz0ibrsxia6fKAqKsDr33jPWrjqM3D7wcRNu/0, createdBy=5a881701729, createdName=小树熊, createdTime=Tue Nov 22 08:41:14 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
    2016-12-16 1e10c84am36(暂无匿称)

    文章不错,值得学习

    0

  8. 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  9. 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createdTime=Tue Nov 22 13:29:00 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157404, encodeId=adc815e40460, content=学习了,哈哈, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRvvXNvY0kOJqn4liar3Q6V6yPuEIawCVUyP3jVADh5icIz0ibrsxia6fKAqKsDr33jPWrjqM3D7wcRNu/0, createdBy=5a881701729, createdName=小树熊, createdTime=Tue Nov 22 08:41:14 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
    2016-11-22 小树熊

    学习了,哈哈

    0

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