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JAMA Inter Med:药物可的松或增加个体急性胰腺炎风险

来源:生物谷 2013-02-26 23:26

2013年2月26日 讯 /生物谷BIOON/ --近日,来自瑞典卡罗琳学院的研究者通过研究表明,肾上腺皮质素类药物(可的松)可以增加急性胰腺炎的风险,该项研究结果刊登于国际杂志JAMA Internal Medicine上,研究者表示,使用可的松治疗的病人应当被告知该药物的风险,而且这些病人应当戒烟戒酒,以免加速发病风险。

急性胰腺炎是一种常见的胰腺疾病,其是由于胰腺突然炎症所引发,很多病人都可以正常恢复。然而患者中有15%至20%会有生命危险。这种疾病常见的引发原因为胆结石和高饮酒量,但是在四分之一的病人中,其发病原因尚不清楚。

此前基于对个体的研究将诶是了,急性胰腺炎和一些药物,比如含可的松的制剂等。由肾上腺激素衍生而来的内源性可的松和压力以及生理节律调节直接相关。合成性的可的松通常用于治疗一些诸如哮喘症或者自身免疫疾病等疾病。

这项研究中,研究者首次系统性的阐述了可的松和急性胰腺炎之间的关系,相比61,000个对照个体来讲,在2006年至2008年间有6000人被诊断为急性胰腺炎患者,研究结果显示,服用可的松药片的个体患急性胰腺炎的风险增加了70%,研究者在个体三天的药物治疗后观察到了可的松和急性胰腺炎之间的关系。

研究者Omid Sadr-Azodi表示,目前对于使用气溶胶可的松的个体(比如哮喘吸入器)来讲并没有观察到其患急性胰腺炎的风险增加,但是进行可的松疗程的个体必须给告诫戒烟以及戒酒,因为烟酒也是急性胰腺炎的发病风险因素。(生物谷Bioon.com)

Association of Oral Glucocorticoid Use With an Increased Risk of Acute Pancreatitis: A Population-Based Nested Case-Control Study

Omid Sadr-Azodi, MD, PhD; Fredrik Mattsson, BSc; Tomas Sjöberg Bexlius, MD, PhD; Mats Lindblad, MD, PhD; Jesper Lagergren, MD, PhD; Rickard Ljung, MD, PhD

Importance Oral glucocorticoid use has been suggested to cause acute pancreatitis in several case reports. However, no epidemiological study has investigated this association. Objective To conduct a nationwide population-based case-control study to investigate the potential association between oral glucocorticoid use and acute pancreatitis. Design In this population-based case-control study, all individuals aged 40 to 84 years who developed a first episode of acute pancreatitis between 2006 and 2008 in Sweden were identified. Setting Population-based, nationwide, register-based study. Participants A total of 6161 cases with a first episode of acute pancreatitis and 61 637 controls were included in the final analyses. Cases were all patients diagnosed as having a first episode of acute pancreatitis during the study period, defined by the diagnosis code K85 in the International Statistical Classification of Diseases, 10th Revision (ICD-10). Controls were randomly selected from the source population at risk of developing acute pancreatitis. For each case, 10 controls, matched for age, sex, and calendar period, were randomly selected from the general population. Oral glucocorticoid use was assessed from the Swedish Prescribed Drug Register. Current, recent, and former users were defined as patients who collected their glucocorticoid prescription within 30, 31 to 180, and after 180 days before the index date, respectively Main Outcome Measures Unconditional logistic regression was performed to calculate the odds ratios (ORs) with 95% confidence intervals for the association between oral glucocorticoid use and acute pancreatitis. Multivariable adjustment was made for potential confounders including, among others, alcohol abuse, diabetes, and concomitant drug use. Results The study included 6161 cases of acute pancreatitis and 61 637 controls. The risk of acute pancreatitis was increased among current users of oral glucocorticoids compared with nonusers (OR, 1.53; 95% CI, 1.27-1.84). This risk was highest 4 to 14 days after drug dispensation (OR, 1.73; 95% CI, 1.31-2.28) and attenuated thereafter. There was no association between oral glucocorticoid use and acute pancreatitis immediately after drug dispensation. There was no increased risk of acute pancreatitis among recent or former users of glucocorticoids compared with nonusers. Conclusions and Relevance Current oral glucocorticoid use is associated with an increased risk of acute pancreatitis.

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