Br J Clin Pharmacol:震惊!吸入类固醇可增加哮喘患者肺炎的发生风险

2017-04-24 MedSci MedSci原创

既往研究表明吸入糖皮质激素(ICS)可增加COPD患者肺炎的发生风险,但是是否会增加哮喘患者肺炎的发生风险目前尚未清楚。,本研究旨在探究ICS是否会增加12-35岁哮喘患者肺炎的发生风险。研究人员使用1990-2007年魁北克健康保险数据库的资料共纳入了152412名研究对象。结果随访期间1928名参与者发生肺炎。分析数据发现当前ICS的使用与肺炎的发生风险相关(RR 1.83;95% CI 1.

既往研究表明吸入糖皮质激素(ICS)可增加COPD患者肺炎的发生风险,但是是否会增加哮喘患者肺炎的发生风险目前尚未清楚。,本研究旨在探究ICS是否会增加12-35岁哮喘患者肺炎的发生风险。

研究人员使用1990-2007年魁北克健康保险数据库的资料共纳入了152412名研究对象。结果随访期间1928名参与者发生肺炎。

分析数据发现当前ICS的使用与肺炎的发生风险相关(RR 1.83;95% CI 1.57-2.14),或与每1000人年增加2.3个病例的发生风险相关(RD 1.44;95% CI 1.03-1.85)。与不使用ICS的参与者相比,使用低剂量(RR 1.60;95% CI 1.06-2.45)、中剂量(RR 1.53;95% CI 1.12-2.08)以及高剂量(RR 1.96;95% CI 1.64-2.34)布地奈德(RR 2.67;95% CI 2.05-3.49)和氟替卡松(RR 1.93;95% CI 1.58-2.36)的参与者均增加了肺炎的发生风险。考虑到偏倚的存在,校正后ICS与肺炎发生之间的关联强度稍有降低(RR 1.48;95% CI 1.22-1.78)。

总而言之,该研究发现哮喘患者使用ICS似乎可增加肺炎的发生风险,且使用布地奈德和氟替卡松时均可发现肺炎的发生风险升高。

原始出处:

Qian CJ, Coulombe J, Suissa S, Ernst P. Pneumonia Risk in Asthma Patients using Inhaled Corticosteroids: A Quasi-Cohort Study. Br J Clin Pharmacol. 2017 Mar 28. doi: 10.1111/bcp.13295.

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    2017-05-24 yb6560
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    2017-06-23 jj000001
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1995970, encodeId=508d19959e022, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Wed May 24 02:19:00 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787235, encodeId=eec01e872354b, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Fri Jun 23 08:19:00 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788205, encodeId=8f921e8820585, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Aug 18 02:19:00 CST 2017, time=2017-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908243, encodeId=d3bd19082434f, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Mon Mar 19 09:19:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313367, encodeId=1b7f131336e63, content=<a href='/topic/show?id=d59be61251d' target=_blank style='color:#2F92EE;'>#类固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76125, encryptionId=d59be61251d, topicName=类固醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Wed Apr 26 05:19:00 CST 2017, time=2017-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190263, encodeId=122b19026304, content=可能与局部免疫抑制有一定关系, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Mon Apr 24 22:09:17 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190204, encodeId=a86e190204c0, content=免疫抑制剂无论什么样的给药方式,副作用都要关注。, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Mon Apr 24 17:19:16 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190164, encodeId=ce4219016436, content=布地奈德还是用得多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83er7lBrMCuvxicCR3XJQhu2X3SmEzicSFDknz19Vav0ln3PHYSicIKQRIiazzcibtEchpeQNrjh2jfOYC0w/132, createdBy=eb931929187, createdName=美丽明天在等我, createdTime=Mon Apr 24 14:34:16 CST 2017, time=2017-04-24, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1995970, encodeId=508d19959e022, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Wed May 24 02:19:00 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787235, encodeId=eec01e872354b, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Fri Jun 23 08:19:00 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788205, encodeId=8f921e8820585, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Aug 18 02:19:00 CST 2017, time=2017-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908243, encodeId=d3bd19082434f, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Mon Mar 19 09:19:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313367, encodeId=1b7f131336e63, content=<a href='/topic/show?id=d59be61251d' target=_blank style='color:#2F92EE;'>#类固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76125, encryptionId=d59be61251d, topicName=类固醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Wed Apr 26 05:19:00 CST 2017, time=2017-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190263, encodeId=122b19026304, content=可能与局部免疫抑制有一定关系, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Mon Apr 24 22:09:17 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190204, encodeId=a86e190204c0, content=免疫抑制剂无论什么样的给药方式,副作用都要关注。, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Mon Apr 24 17:19:16 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190164, encodeId=ce4219016436, content=布地奈德还是用得多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83er7lBrMCuvxicCR3XJQhu2X3SmEzicSFDknz19Vav0ln3PHYSicIKQRIiazzcibtEchpeQNrjh2jfOYC0w/132, createdBy=eb931929187, createdName=美丽明天在等我, createdTime=Mon Apr 24 14:34:16 CST 2017, time=2017-04-24, status=1, ipAttribution=)]
    2017-04-24 lovetcm

    可能与局部免疫抑制有一定关系

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1995970, encodeId=508d19959e022, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Wed May 24 02:19:00 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787235, encodeId=eec01e872354b, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Fri Jun 23 08:19:00 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788205, encodeId=8f921e8820585, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Aug 18 02:19:00 CST 2017, time=2017-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908243, encodeId=d3bd19082434f, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Mon Mar 19 09:19:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313367, encodeId=1b7f131336e63, content=<a href='/topic/show?id=d59be61251d' target=_blank style='color:#2F92EE;'>#类固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76125, encryptionId=d59be61251d, topicName=类固醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Wed Apr 26 05:19:00 CST 2017, time=2017-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190263, encodeId=122b19026304, content=可能与局部免疫抑制有一定关系, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Mon Apr 24 22:09:17 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190204, encodeId=a86e190204c0, content=免疫抑制剂无论什么样的给药方式,副作用都要关注。, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Mon Apr 24 17:19:16 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190164, encodeId=ce4219016436, content=布地奈德还是用得多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83er7lBrMCuvxicCR3XJQhu2X3SmEzicSFDknz19Vav0ln3PHYSicIKQRIiazzcibtEchpeQNrjh2jfOYC0w/132, createdBy=eb931929187, createdName=美丽明天在等我, createdTime=Mon Apr 24 14:34:16 CST 2017, time=2017-04-24, status=1, ipAttribution=)]
    2017-04-24 医张生

    免疫抑制剂无论什么样的给药方式,副作用都要关注。

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1995970, encodeId=508d19959e022, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Wed May 24 02:19:00 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787235, encodeId=eec01e872354b, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Fri Jun 23 08:19:00 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788205, encodeId=8f921e8820585, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Aug 18 02:19:00 CST 2017, time=2017-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908243, encodeId=d3bd19082434f, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Mon Mar 19 09:19:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313367, encodeId=1b7f131336e63, content=<a href='/topic/show?id=d59be61251d' target=_blank style='color:#2F92EE;'>#类固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76125, encryptionId=d59be61251d, topicName=类固醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Wed Apr 26 05:19:00 CST 2017, time=2017-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190263, encodeId=122b19026304, content=可能与局部免疫抑制有一定关系, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Mon Apr 24 22:09:17 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190204, encodeId=a86e190204c0, content=免疫抑制剂无论什么样的给药方式,副作用都要关注。, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Mon Apr 24 17:19:16 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190164, encodeId=ce4219016436, content=布地奈德还是用得多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83er7lBrMCuvxicCR3XJQhu2X3SmEzicSFDknz19Vav0ln3PHYSicIKQRIiazzcibtEchpeQNrjh2jfOYC0w/132, createdBy=eb931929187, createdName=美丽明天在等我, createdTime=Mon Apr 24 14:34:16 CST 2017, time=2017-04-24, status=1, ipAttribution=)]
    2017-04-24 美丽明天在等我

    布地奈德还是用得多哦

    0

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