Clin Gastroenterology H: 使用质子泵抑制剂会增加发生肾结石的风险

2021-01-02 MedSci原创 MedSci原创

质子泵抑制剂(PPI)是一类减少胃酸产生的药物,可用于治疗包括胃食管反流病(GERD)和消化性溃疡在内的几种消化疾病。

      质子泵抑制剂(PPI)是一类减少胃酸产生的药物,可用于治疗包括胃食管反流病(GERD)和消化性溃疡在内的几种消化疾病尽管人们普遍对此药有良好评价,但越来越多的文献发现在慢性肾脏疾病和肠感染的条件下使用PPI时,肠对于钙吸收减少,尿液减少钙排泄会导致肾结石,特别是草酸钙结石的出现。因此,本项研究旨在探究PPI使用与肾结石之间的关联。

 

      研究人员收集了从1999年10月1日至2017年9月30日间的退伍军人队列研究的数据进行了一项回顾性研究。总共收集到465891例患者的PPI使用情况,以及相应的人口统计,实验室结果,合并症,和药物使用情况数据。Cox比例风险和倾向匹配分析确定了PPI使用的风险和肾结石的发生相关性。

 

 

      在未经校正的分析中,PPI的使用与肾结石存在正相关性,PPI的使用是随时间变化的变量(危险比[HR]为1.74; 95%CI,1.67-1.82),并在校正后的分析中持续存在这样的影响(HR为1.46; P <0.05) 95%CI,1.38–1.55)。PPI剂量增加与肾结石风险增加相关(HR,1.11; 95%CI,1.09–1.14)。组胺药物(H2RAs)的使用也与肾结石的风险增加相关(校正后的HR,1.47; CI 1.31-1.64)。在调整后的分析中,研究人员还发现左甲状腺素与肾结石的使用无关联(调整后的HR为1.06; 995%CI,0.94-1.21)。

 

      研究最后,作者说道,在这项大型的队列研究中,他们发现PPI的使用与肾结石风险呈剂量依赖性增加相关关系。H2RAs的使用也与肾结石的风险有关,因此抑制酸可能是其中的一个机制。

 

原始出处:

Michael Simonov. Et al. Use of Proton Pump Inhibitors Increases Risk of Incident Kidney Stones. Clinical Gastroenterology Hepatology. 2021.

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    2023-03-04 lifestar 来自上海

    #质子泵抑制剂#会增加发生#肾结石#的风险

    0

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    2021-06-09 许安
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    2021-10-19 jklm09
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  8. [GetPortalCommentsPageByObjectIdResponse(id=2117480, encodeId=bed4211e48005, content=<a href='/topic/show?id=02f99235e23' target=_blank style='color:#2F92EE;'>#质子泵抑制剂#</a>会增加发生<a href='/topic/show?id=07058265569' target=_blank style='color:#2F92EE;'>#肾结石#</a>的风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92357, encryptionId=02f99235e23, topicName=质子泵抑制剂), TopicDto(id=82655, encryptionId=07058265569, topicName=肾结石)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Sat Mar 04 13:16:12 CST 2023, time=2023-03-04, status=1, ipAttribution=上海), GetPortalCommentsPageByObjectIdResponse(id=2073201, encodeId=a92f20e3201a9, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, 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=Wed Jun 09 07:04:18 CST 2021, time=2021-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2065233, encodeId=469d2065233df, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri Jul 02 01:04:18 CST 2021, time=2021-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712650, encodeId=86ae1e126507b, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Aug 11 18:04:18 CST 2021, time=2021-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667384, encodeId=3383166e384f2, 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=31, 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=Mon Nov 29 17:04:18 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852572, encodeId=da9a18525e27a, 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=36, 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=Tue Oct 19 03:04:18 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505154, encodeId=2f731505154f1, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Mon Jan 04 11:04:18 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913311, encodeId=4545913311af, content=已阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201230/ea6e8f75bed34badb45686736e50d717/35fec8cdc1764e2989ef631d7aaa2978.jpg, createdBy=e41c2026322, createdName=rocker, createdTime=Sun Jan 03 14:56:41 CST 2021, time=2021-01-03, status=1, ipAttribution=)]
    2021-01-03 rocker

    已阅读

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