Lai Shih-Wei, Lin Cheng-Li, Liao Kuan-Fu
School of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
Department of Public Health, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Int J Cardiol. 2015 Feb 15;181:235-8. doi: 10.1016/j.ijcard.2014.11.217. Epub 2014 Nov 27.
The goal of this study was to evaluate the association between digoxin use and acute pancreatitis in Taiwan.
Utilizing the database of the Taiwan National Health Insurance Program, this case-control study consisted of 6116 subjects aged 20-84years with a first-attack of acute pancreatitis since 2000 to 2011 as the cases and 24,464 randomly selected subjects without acute pancreatitis as the controls. Both cases and controls were matched by sex, age and index year of diagnosing acute pancreatitis. The absence of digoxin prescription was defined as "never use". Active use of digoxin was defined as subjects who at least received 1 prescription for digoxin within 7days before the date of diagnosing acute pancreatitis. Non-active use of digoxin was defined as subjects who did not receive a prescription within 7days but at least received 1 prescription for digoxin ≥8days before the date of diagnosing acute pancreatitis. The odds ratio (OR) and 95% confidence interval (CI) were measured to evaluate the association between digoxin use and acute pancreatitis by a multivariable unconditional logistic regression model.
After adjusting for potential confounding factors, the adjusted OR of acute pancreatitis was 5.29 for subjects with active use of digoxin (95% CI 3.61, 7.73), when compared with subjects with never use of digoxin. The adjusted OR of acute pancreatitis decreased to 1.04 for subjects with non-active use of digoxin (95% CI 0.89, 1.21), but no statistical significance.
These data indicate that only persons actively using digoxin may have the high relative odds of acute pancreatitis. Further research or case report is warranted to evaluate the pathophysiological basis underlying the relationship between digoxin use and acute pancreatitis.
本研究旨在评估台湾地区地高辛使用与急性胰腺炎之间的关联。
利用台湾全民健康保险计划数据库，这项病例对照研究纳入了6116名年龄在20至84岁之间、自2000年至2011年首次发作急性胰腺炎的患者作为病例组，以及24464名随机选取的无急性胰腺炎的受试者作为对照组。病例组和对照组按性别、年龄及急性胰腺炎诊断的索引年份进行匹配。未开具地高辛处方被定义为“从未使用”。地高辛的活跃使用定义为在诊断急性胰腺炎日期前7天内至少接受过1次地高辛处方的受试者。地高辛的非活跃使用定义为在诊断急性胰腺炎日期前7天内未接受处方，但在诊断急性胰腺炎日期前≥8天至少接受过1次地高辛处方的受试者。通过多变量无条件逻辑回归模型测量比值比（OR）和95%置信区间（CI），以评估地高辛使用与急性胰腺炎之间的关联。
在调整潜在混杂因素后，与从未使用地高辛的受试者相比，活跃使用地高辛的受试者急性胰腺炎的调整后OR为5.29（95%CI 3.61, 7.73）。地高辛非活跃使用的受试者急性胰腺炎的调整后OR降至1.04（95%CI 0.89, 1.21），但无统计学意义。
这些数据表明，只有活跃使用地高辛的人群可能有较高的急性胰腺炎相对发病几率。有必要进行进一步研究或病例报告以评估地高辛使用与急性胰腺炎之间关系的病理生理基础。
