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2000 年至 2009 年美国药物不良反应和血管性水肿住院治疗情况。

Adverse drug effects and angioedema hospitalizations in the United States from 2000 to 2009.

机构信息

Department of Medicine, New York Downtown Hospital, New York, NY 10038, USA.

出版信息

Allergy Asthma Proc. 2013 Jan-Feb;34(1):65-71. doi: 10.2500/aap.2013.34.3618.

Abstract

Since angiotensin-converting enzyme (ACE) inhibitors became common treatments, there have been increasing reports of angioedema (AE). AE hospitalization (AEH) trend data in the new millennium are limited. This study calculates hospitalization rates for AEs and describes clinical characteristics of AEHs in the United States, especially as related to specific adverse drug effects (ADEs). The National Inpatient Samples 2000-2009 were queried for AEHs to calculate hospitalization rates and to examine for associations with specified ADEs, certain comorbidities, and demographic features. AEHs requiring intubation or tracheostomy were also examined for associations. There was a significant increase in the AEH rates (3.4 per 10(5) to 5.4 per 10(5)) over the study period (p < 0.0001) and the hospitalization rates for African Americans (AAs) were consistently higher. Throughout the study the proportions of AEH coding any ADEs, or an ADE due to a cardiovascular (CV) or antihypertensive (aHTN) drug increased over time. By 2009, 61.7% AEHs coded an ADE. Of these, 58.7% were caused by CV or aHTN drugs. In AEHs, having an ADE from a CV or aHTN medication had the strongest adjusted associations with hypertension and renal disease as well as with alcohol-related disorders. In AEHs, intubation/tracheostomy had the strongest ADE associations related to CV or aHTN medication (adjusted odds ratio, 1.4; 95% CI, 1.3, 1.6). AEHs continue to increase, but this can only be partially attributed to ACE inhibitor usage. Intubation/tracheostomy appears to be greater in AEHs with ADE due to CV/aHTN drugs. Alcohol-related disorders may have a role in ACE inhibitor-associated AEH.

摘要

自从血管紧张素转换酶(ACE)抑制剂成为常见的治疗方法以来,越来越多的血管性水肿(AE)报告。新世纪 ACE 住院(AEH)趋势数据有限。本研究计算了美国 AE 的住院率,并描述了 AEH 的临床特征,特别是与特定药物不良反应(ADE)相关的特征。查询了 2000-2009 年国家住院样本中 AEH 的住院率,并检查了与特定 ADE、某些合并症和人口统计学特征的关联。还检查了需要插管或气管切开的 AEH 的关联。在研究期间,AEH 率(从每 105 人 3.4 人增加到每 105 人 5.4 人)显著增加(p < 0.0001),非裔美国人(AA)的住院率一直较高。在整个研究过程中,AEH 编码任何 ADE 或因心血管(CV)或抗高血压(aHTN)药物引起的 ADE 的比例随着时间的推移而增加。到 2009 年,61.7%的 AEH 编码 ADE。其中,58.7%是由 CV 或 aHTN 药物引起的。在 AEH 中,由于 CV 或 aHTN 药物引起的 ADE 与高血压和肾脏疾病以及与酒精相关的疾病具有最强的调整关联。在 AEH 中,与 CV 或 aHTN 药物相关的插管/气管切开术与 ADE 具有最强的关联(调整后的优势比,1.4;95%置信区间,1.3,1.6)。AEH 继续增加,但这只能部分归因于 ACE 抑制剂的使用。与 CV/aHTN 药物相关的 ADE 引起的 AEH 似乎插管/气管切开术的比例更高。酒精相关疾病可能与 ACE 抑制剂相关的 AEH 有关。

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