| 金澄滔,夏道宗.质子泵抑制剂致急性肾损伤-巢式病例对照研究[J].浙江中西医结合杂志,2022,32(12): |
| 质子泵抑制剂致急性肾损伤-巢式病例对照研究 |
| Proton pump inhibitors induce acute kidney injury: a nested case control study |
| 投稿时间：2022-09-05 修订日期：2022-11-22 |
| DOI： |
| 中文关键词: 质子泵抑制剂 急性肾损伤 巢式病例对照 |
| 英文关键词:PPIs AKI NCCS |
| 基金项目: |
|
| 摘要点击次数: 529 |
| 全文下载次数: 6 |
| 中文摘要: |
| 背景 质子泵抑制剂(proton pump inhibitors,PPIs)是目前国际和国内应用最广泛的药物之一,全球多项流行病学调查和回顾性病例研究均认为该类药物是导致急性肾损伤(acute kidney injury,AKI)的常见药物,但国内文献少见报道。目的 基于杭州某三甲医院3个院区近13年的病历数据库,探讨质子泵抑制剂导致AKI的发生情况及其影响因素,为临床治疗和预防提供依据。方法 采用巢式病例对照研究,根据设定的纳排标准,选取2009年1月1日-2022年1月1日使用PPIs后出现AKI的患者共112例进入研究队列作为病例组,按照约1:4比例匹配同时段未发生AKI的患者作为对照组,采集患者性别、年龄、血常规、合并疾病等相关信息,采用多因素Logistic回归分析等统计方法,探讨发生急性肾损伤的因素。结果 AKI患者平均年龄68.94岁,其中女性有67例,占比59.8%；男性45例,占比40.2%。多因素Logistic回归分析显示性别（OR=1.19；95%CI：1.03~1.28）、年龄（OR=1.74；95%CI：1.42~2.13）、重症感染（OR=5.24；95%CI：4.13~6.84）是患者发生肾功能损伤的危险因素。结论 使用PPIs的患者不建议常规接受肾功能检测,但对于本身存在肾功能不全的患者则应审慎使用,老年患者尤其是老年女性在合并重症感染时,必须考虑加强尿液和肾功能检查。 |
| 英文摘要: |
| ABSTRACT Background Proton pump inhibitors (PPIs) are one of the most widely used drugs at home and abroad. Several epidemiological investigations and retrospective case studies around the world believe that PPIs are common drugs causing acute kidney injury (AKI), but there are few reports on this in China. Objective To investigate the incidence and influencing factors of PPIs -AKI based on the 13 years medical record database of 3 campuses of a grade iii hospital in Hangzhou, and to provide evidence for clinical treatment and prevention. Methods Using nested case control study method, according to the set standards, select 112 cases with AKI after use of PPIs as case group and 400 cases without AKI as control group from January 1, 2009 to January 1, 2022. The gender, age, blood routine examination, combined diseases and other related information were collected. Multivariate logistic regression analysis was used to explore the reasons of AKI. Results The average age of patients with AKI was 68.94 years old, and 67 of them were female, accounting for 59.8%. There were 45 males, accounting for 40.2%. Multivariate Logistic regression analysis indicates gender（OR=1.19；95%CI：1.03~1.28）, age (OR=1.74; 95%CI: 1.42-2.13) and severe infection (OR=5.24; 95%CI: 4.13-6.84) were risk factors for AKI. Conclusions Routine renal function testing is not recommended for common patients, but PPIs should be used very carefully for patients with renal insufficiency. Elderly patients, especially elderly women, should consider strengthening renal function testing when complicated with severe infection. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
