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一项基于人群的关于他汀类药物暴露与急性憩室病风险的病例对照研究。

A population-based case-control study on statin exposure and risk of acute diverticular disease.

作者信息

Sköldberg Filip, Svensson Tobias, Olén Ola, Hjern Fredrik, Schmidt Peter T, Ljung Rickard

机构信息

a Department of Surgical Sciences , Uppsala University , Uppsala , Sweden .

b Clinical Epidemiology Unit, Department of Medicine Solna , Karolinska Institutet , Stockholm , Sweden .

出版信息

Scand J Gastroenterol. 2016;51(2):203-10. doi: 10.3109/00365521.2015.1081274. Epub 2015 Sep 10.

Abstract

OBJECTIVE

A reduced risk of perforated diverticular disease among individuals with current statin exposure has been reported. The aim of the present study was to investigate whether statins reduce the risk of acute diverticular disease.

MATERIAL AND METHODS

A nation-wide population-based case-control study was performed, including 13,127 cases hospitalised during 2006-2010 with a first-time diagnosis of colonic diverticular disease, and 128,442 control subjects (matched for sex, age, county of residence and calendar year). Emergency surgery, assumed to be a proxy for complicated diverticulitis, was performed on 906 of the cases during the index admission, with 8818 matched controls. Statin exposure was classified as "current" or "former" if a statin prescription was last dispensed ≤ 125 days or >125 days before index date, respectively. The association between statin exposure and acute diverticular disease was investigated by conditional logistic regression, including models adjusting for country of birth, educational level, marital status, comorbidities, nonsteroidal anti-inflammatory drug/steroid exposure and healthcare utilisation.

RESULTS

A total of 1959 cases (14.9%) and 16,456 controls (12.8%) were current statin users (crude OR 1.23 [95% CI 1.17-1.30]; fully adjusted OR 1.00 [0.94-1.06]). One hundred and thirty-two of the cases subjected to surgery (14.6%), and 1441 of the corresponding controls (16.3%) were current statin users (crude OR 0.89 [95% CI 0.73-1.08]; fully adjusted OR 0.70 [0.55-0.89]).

CONCLUSIONS

The results do not indicate that statins affect the development of symptomatic diverticular disease in general. However, current statin use was associated with a reduced risk of emergency surgery for diverticular disease.

摘要

目的

有报道称,目前正在服用他汀类药物的个体患憩室穿孔性疾病的风险降低。本研究的目的是调查他汀类药物是否能降低急性憩室病的风险。

材料与方法

开展了一项全国性的基于人群的病例对照研究,纳入了2006年至2010年期间首次诊断为结肠憩室病并住院的13127例患者,以及128442名对照者(按性别、年龄、居住县和日历年进行匹配)。在首次入院期间,906例患者接受了急诊手术,假定其为复杂性憩室炎的代表,另有8818名匹配的对照者。如果他汀类药物处方在索引日期前最后一次配药分别≤125天或>125天,则他汀类药物暴露被分类为“当前”或“既往”。通过条件逻辑回归研究他汀类药物暴露与急性憩室病之间的关联,包括对出生国家、教育水平、婚姻状况、合并症、非甾体抗炎药/类固醇暴露和医疗保健利用情况进行调整的模型。

结果

共有1959例患者(14.9%)和16456名对照者(12.8%)为当前他汀类药物使用者(粗比值比1.23 [95%置信区间1.17 - 1.30];完全调整后的比值比1.00 [0.94 - 1.06])。接受手术的132例患者(14.6%)和相应的1441名对照者(16.3%)为当前他汀类药物使用者(粗比值比0.89 [95%置信区间0.73 - 1.08];完全调整后的比值比0.70 [0.55 - 0.89])。

结论

结果并未表明他汀类药物总体上会影响有症状憩室病的发展。然而,当前使用他汀类药物与憩室病急诊手术风险降低相关。

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