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BMJ. 2006 Oct 7;333(7571):726. doi: 10.1136/bmj.38947.697558.AE. Epub 2006 Sep 19.
2
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Aliment Pharmacol Ther. 2006 Sep 15;24(6):897-908. doi: 10.1111/j.1365-2036.2006.03077.x.
3
Spironolactone and risk of upper gastrointestinal events: population based case-control study.螺内酯与上消化道事件风险：基于人群的病例对照研究
BMJ. 2006 Aug 12;333(7563):330. doi: 10.1136/bmj.38883.479549.2F. Epub 2006 Jul 13.
4
[Pharmacoepidemiology].[药物流行病学]
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Aldosterone inhibition limits collagen synthesis and progressive left ventricular enlargement after anterior myocardial infarction.醛固酮抑制可限制前壁心肌梗死后的胶原合成和左心室进行性扩大。
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Association between nonsteroidal anti-inflammatory drugs and upper gastrointestinal tract bleeding/perforation: an overview of epidemiologic studies published in the 1990s.非甾体抗炎药与上消化道出血/穿孔之间的关联：20世纪90年代发表的流行病学研究综述。
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9
The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.螺内酯对重度心力衰竭患者发病率和死亡率的影响。随机螺内酯评估研究调查组。
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螺内酯的使用与上消化道出血风险：一项基于人群的病例对照研究。

Spironolactone use and the risk of upper gastrointestinal bleeding: a population-based case-control study.

作者信息

Gulmez Sinem E, Lassen Annmarie T, Aalykke Claus, Dall Michael, Andries Alin, Andersen Birthe S, Hansen Jane M, Andersen Morten, Hallas Jesper

机构信息

Research Unit of Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, Odense, Denmark.

出版信息

Br J Clin Pharmacol. 2008 Aug;66(2):294-9. doi: 10.1111/j.1365-2125.2008.03205.x. Epub 2008 Apr 21.

DOI:10.1111/j.1365-2125.2008.03205.x
PMID:18507655
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2492928/
Abstract

AIMS

Recent studies have suggested an increased risk of upper gastrointestinal bleeding (UGB) in spironolactone users. The aim was to confirm the association, identify the risk factors and quantify the absolute risk.

METHODS

A population based case-control study was conducted in the County of Funen, Denmark. Cases (n = 3652) were all subjects with a first discharge diagnosis of serious UGB during the period 1995 to 2006. Age- and gender-matched controls (10 for each case) (n = 36 502) were selected by risk set sampling. Data on all subjects' drug exposure and past medical history were retrieved from a prescription database and from the County's patient register. Confounders were controlled by conditional logistic regression.

RESULTS

The adjusted odds ratio (OR) associating current use of spironolactone with UGB was 2.7 [95% confidence interval (CI) 2.2, 3.2]. The risk increased with higher doses of spironolactone (5.4; 3.4, 8.6) for 100-mg tablets. No trend was found with increasing cumulative dose. The strongest association was found among users aged 55-74 years (OR 13.1; 6.5, 26.3). Current use of loop diuretics was also associated with an increased risk of UGB (1.9; 1.7, 2.1).

CONCLUSION

The use of spironolactone is associated with increased risk of UGB. The risk increases with higher doses.

摘要

目的

近期研究表明，使用螺内酯会增加上消化道出血（UGB）的风险。本研究旨在证实这种关联，确定风险因素并量化绝对风险。

方法

在丹麦菲英岛进行了一项基于人群的病例对照研究。病例（n = 3652）为1995年至2006年期间首次出院诊断为严重上消化道出血的所有患者。通过风险集抽样选择年龄和性别匹配的对照（每个病例10名）（n = 36502）。从处方数据库和该县的患者登记册中检索所有受试者的药物暴露和既往病史数据。通过条件逻辑回归控制混杂因素。

结果

当前使用螺内酯与上消化道出血相关的校正比值比（OR）为2.7 [95%置信区间（CI）2.2, 3.2]。对于100毫克片剂，随着螺内酯剂量增加风险升高（5.4；3.4, 8.6）。未发现随着累积剂量增加有趋势。在55 - 74岁的使用者中发现最强的关联（OR 13.1；6.5, 26.3）。当前使用袢利尿剂也与上消化道出血风险增加相关（1.9；1.7, 2.1）。

结论

使用螺内酯与上消化道出血风险增加相关。风险随剂量增加而升高。