痛风APP-别痛风为用户提供食物嘌呤查询、痛风相关知识、痛风食疗食谱,陪伴大家一起走过这些疼痛的日子。
当前位置: 首页 > 痛风研究进展 >长期应用苯溴马隆可显著降低痛风患者冠心病发生风险

长期应用苯溴马隆可显著降低痛风患者冠心病发生风险

时间:2017-06-28 作者: 高高高高

文献来源Hsiu-Chen Lin et al, International Journal of Cardiology 233 (2017) 85–90.


全文内容摘要

背景:

痛风对冠状动脉疾病(CAD)进展的作用与风险并不确定,有研究发现痛风是急性心肌梗死的危险因素。本文研究调查痛风病人服用苯溴马隆或别嘌呤醇后对冠状动脉疾病的风险,并分析这两种药物与冠状动脉疾病(CAD)发病率的剂量效应关系。


方法:

2000年-2011年台湾医疗保险研究数据库提供的一百万例医疗记录。Cox比例风险比用来比较痛风病人服用别嘌呤醇或苯溴马隆或不服用药物对CAD疾病的风险。HR风险比调整了疾病相关的混杂因素:包括年龄、性别、高血压、高脂血症、糖尿病、慢性肾脏疾病和相关药物。


结果:

8047例痛风患者,1422例用单独服用别嘌呤醇(A组),4141例单独服用苯溴马隆(B组),2484例两种药物联用(A / B组)。研究结果显示,A组、B组、A/ B组调整后冠心病的发病率无显著差异。但是在进行剂量反应分析后发现,服用别嘌醇(400mg/d)连续治疗时间超过270日,苯溴马隆(100mg/d)连续治疗时间超过360日时,可显著降低CAD的风险。


结论:

研究结果发现苯溴马隆单用超过360天后,与0-90天对比,冠心病发生风险减少54%(HR 0.46,95%CI, 0.34–0.60,P<0.001);苯溴和别嘌醇联用超过360天后,与0-90天对比,冠心病发生风险减少56% ( HR 0.44,95%CI,0.31–0.63),P<0.001)。在更长的使用时间上,苯溴马隆和别嘌醇无论单用或联用,均可降低痛风患者冠心病的发生风险,特别是在高剂量时,这种相关性更为明确。




附英文原文


Background: The effect of gout on the risk of developing coronary artery disease (CAD) is uncertain. Some studies have found that gout is a risk factor for acute myocardial infarction. This study examined the changes in risk of CAD in gout patients taking allopurinol and/or benzbromarone, and analyzed the dose-response relationship of both drugs with CAD incidence.

Methods: The medical records of one million subjects from 2000 to 2011 were provided by the Taiwan National Health Insurance Research Database. Cox proportional hazard ratio was used to compare the risk of CAD in gout patients taking allopurinol or/and benzbromarone with those taking neither drug. Hazard ratios (HR) were adjusted for possible confounding factors, including age, gender, hypertension, hyperlipidemia, diabetesmellitus, chronic kidney disease, and relevant medications.

Results: Of 8047 gout patients, 1422 were treatedwith allopurinol (Group A), 4141 with benzbromarone (Group B), and 2484 with both drugs (Group A/B) during the follow-up period. Our results showed the incidence of CAD after adjusting for covariates for Group A, Group B, and Group A/B did not significantly differ fromthe comparison group. However, after adjustment for covariates in dose-response analyses, treatment with over 270 defined daily doses (DDDs) of allopurinol, and over 360 DDDs of benzbromarone, was associated with a significantly

reduced risk of CAD.

Conclusion: We found that the use of allopurinol and benzbromarone, whether alone or in combination, had a linear dose-response relationship between the numbers of defined daily doses and the risk of CAD, especially in higher DDDs.


文章标题:Allopurinol, benzbromarone and risk of coronary heart disease in gout patients: A population-based study

别痛风

食物嘌呤随手查!

立即打开