苯二氮䓬类药物的使用与良性脑肿瘤的发生之间的关联。

An association between benzodiazepine use and occurrence of benign brain tumors.

作者信息

Harnod Tomor, Lin Cheng-Li, Sung Fung-Chang, Kao Chia-Hung

机构信息

Department of Neurosurgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; College of Medicine, Tzu Chi University, Hualien, Taiwan.

Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.

出版信息

J Neurol Sci. 2014 Jan 15;336(1-2):8-12. doi: 10.1016/j.jns.2013.11.009. Epub 2013 Nov 16.

DOI:10.1016/j.jns.2013.11.009

PMID:24314718

Abstract

OBJECTIVE

This study was designed to evaluate the impact of long-term benzodiazepine use on the subsequent risk of benign brain tumor (BBT) or malignant brain tumor (MBT) development.

METHOD

We used data from the National Health Insurance System of Taiwan. For the study cohort, we identified 62,186 patients who had been prescribed benzodiazepine for at least 2 months between January 1, 2000 and December, 31, 2009. For each of the benzodiazepine cases, we randomly selected one insured person from the non-benzodiazepine cohort with frequency matching sex, age, and year of index date. The non-benzodiazepine cohort comprised 62,050 patients. The related hazard ratios (HRs) and 95% confidence intervals (CIs) of developing brain tumors were investigated.

RESULTS

The overall BBT incidence rate was 3.33-fold higher in the benzodiazepine cohort than the non-benzodiazepine cohort (46.3 vs 13.9 per 100,000 person-years) with an adjusted HR of 3.15 (95% CI=2.37-4.20). Similarly, the MBT incidence rate was 84% higher in the benzodiazepine cohort (3.71 vs 2.02 per 1000 person-years), and the adjusted HR of 1.21 (95% CI=0.52-2.81) was not statistically significant. When compared with the non-benzodiazepine cohort, the adjusted HRs of BBTs increased with benzodiazepine dosage (adjusted HR=2.12, 95% CI=1.45-3.10, for 36-150 mg/year; adjusted HR=7.03, 95% CI=5.19-9.51, for ≥151 mg/year).

CONCLUSION

In this population-based study, we found a significant increase in the risk of benign brain tumor development in a cohort of long-term BZD users.

摘要

目的

本研究旨在评估长期使用苯二氮䓬类药物对后续发生良性脑肿瘤（BBT）或恶性脑肿瘤（MBT）风险的影响。

方法

我们使用了台湾国民健康保险系统的数据。对于研究队列，我们确定了2000年1月1日至2009年12月31日期间至少服用苯二氮䓬类药物2个月的62186例患者。对于每例苯二氮䓬类药物使用者，我们从非苯二氮䓬类药物队列中随机选择一名保险对象，使其在性别、年龄和索引日期年份上频率匹配。非苯二氮䓬类药物队列包括62050例患者。研究了发生脑肿瘤的相关风险比（HRs）和95%置信区间（CIs）。

结果

苯二氮䓬类药物队列中BBT的总体发病率比非苯二氮䓬类药物队列高3.33倍（每10万人年分别为46.3例和13.9例），调整后的HR为3.15（95%CI=2.37-4.20）。同样，苯二氮䓬类药物队列中MBT的发病率高84%（每1000人年分别为3.71例和2.02例），调整后的HR为1.21（95%CI=0.52-2.81），无统计学意义。与非苯二氮䓬类药物队列相比，BBT的调整后HR随苯二氮䓬类药物剂量增加而升高（每年36-150mg，调整后HR=2.12，95%CI=1.45-3.10；每年≥151mg，调整后HR=7.03，95%CI=5.19-9.51）。