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他汀类药物的使用与急性胰腺炎风险:一项基于人群的病例对照研究。

Use of statins and the risk of acute pancreatitis: a population-based case-control study.

作者信息

Kuoppala Jaana, Pulkkinen Jukka, Kastarinen Helena, Kiviniemi Vesa, Jyrkkä Johanna, Enlund Hannes, Happonen Pertti, Paajanen Hannu

机构信息

Finnish Medicines Agency, Kuopio, Finland.

Kuopio University Hospital, Kuopio, Finland.

出版信息

Pharmacoepidemiol Drug Saf. 2015 Oct;24(10):1085-92. doi: 10.1002/pds.3858. Epub 2015 Aug 24.

Abstract

PURPOSE

The aim of this research was to examine the association between statin use and the risk of acute pancreatitis.

METHODS

This register-based case-control study with incidence density sampling was based on 4376 patients hospitalized in 2008-2010 for acute pancreatitis and 19 859 randomly selected age and sex-matched controls from the adult population of Finland. The relationship between statin use from 1 January 2004 to the index date and the relative incidence rate of acute pancreatitis was modelled by conditional logistic regression. The rate ratios were adjusted for comorbidities.

RESULTS

A total of 826 (19%) cases and 2589 (13%) controls had been exposed to statins. Statin use was associated with an increased incidence rate of acute pancreatitis (odds ratio (OR) 1.25, 95% confidence interval (CI) 1.13-1.39). This increase was seen especially during the first year of use both among current (OR 1.37, 95% CI 0.94-2.00 for at most 3 months of use and OR 1.32, 95% CI 1.07-1.63 for 4-12 months of use) and former users (OR 1.64, 95% CI 1.33-2.03). The overall association remained when restricting analyses to participants with current use only, or with no history of gallstone or alcohol-related diseases, or with no comorbidities or medicines other than statins.

CONCLUSIONS

Statin use seems to be associated with an increased risk of acute pancreatitis. The association is more apparent during the first year of statin use and among former users.

摘要

目的

本研究旨在探讨他汀类药物使用与急性胰腺炎风险之间的关联。

方法

这项基于登记的病例对照研究采用发病密度抽样方法,研究对象为2008年至2010年因急性胰腺炎住院的4376例患者,以及从芬兰成年人口中随机选取的19859例年龄和性别匹配的对照。通过条件逻辑回归对2004年1月1日至索引日期的他汀类药物使用与急性胰腺炎相对发病率之间的关系进行建模。发病率比值针对合并症进行了调整。

结果

共有826例(19%)病例和2589例(13%)对照曾使用过他汀类药物。使用他汀类药物与急性胰腺炎发病率增加相关(比值比(OR)为1.25,95%置信区间(CI)为1.13 - 1.39)。这种增加在使用的第一年尤为明显,无论是当前使用者(使用最多3个月时,OR为1.37,95%CI为0.94 - 2.00;使用4 - 12个月时,OR为1.32,95%CI为1.07 - 1.63)还是既往使用者(OR为1.64,95%CI为1.33 - 2.03)。当仅对当前使用者、无胆结石或酒精相关疾病史者、无合并症或除他汀类药物外无其他药物的参与者进行分析时,总体关联仍然存在。

结论

使用他汀类药物似乎与急性胰腺炎风险增加相关。这种关联在他汀类药物使用的第一年以及既往使用者中更为明显。

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