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质子泵抑制剂与肺结核的相关性:台湾地区的一项病例对照研究

Correlation of Proton Pump Inhibitors with Pulmonary Tuberculosis: A Case-Control Study in Taiwan.

作者信息

Cheng Kao-Chi, Liao Kuan-Fu, Lin Cheng-Li, Lai Shih-Wei

机构信息

College of Medicine, China Medical UniversityTaichung, Taiwan.

Department of Family Medicine, China Medical University HospitalTaichung, Taiwan.

出版信息

Front Pharmacol. 2017 Jul 19;8:481. doi: 10.3389/fphar.2017.00481. eCollection 2017.

Abstract

Although the relationship between the use of proton pump inhibitors (PPIs) and pulmonary tuberculosis (TB) in Taiwan published in 2014. Due to just only one article and not enough comprehensively, we explore this issue. We conducted a population-based case-control study to identify 9,422 subjects aged 20 years or older with newly diagnosed pulmonary TB in 2000-2013 as test cases. We then randomly selected 9,422 subjects aged 20 years or older without pulmonary TB as controls. Both cases and controls were matched in terms of sex, age, and comorbidities. Use of PPIs were defined as subjects who had had at least one prescription for these medications before the index date. No use was defined as subjects who had never had a prescription for PPIs before the index date. The odds ratio (OR) and 95% confidence interval (CI) for pulmonary TB associated with PPI use was estimated using the logistic regression model. The OR of pulmonary TB was 1.31 for subjects who had used PPIs (95% CI 1.22, 1.41) compared with those with no use of the medications. Sub-analysis revealed the OR of pulmonary TB in subjects using PPI per increasing microgram was 1.25 (95% CI 1.19, 1.30). PPI use is associated with a 1.3-fold increase in odds of developing pulmonary TB in Taiwan. There is a dose-related response between PPI use and pulmonary TB.

摘要

尽管2014年有关于台湾地区质子泵抑制剂(PPI)使用与肺结核(TB)之间关系的报道。但由于仅有一篇文章且不够全面,我们对该问题进行了探究。我们开展了一项基于人群的病例对照研究,确定2000年至2013年期间9422名20岁及以上新诊断为肺结核的受试者作为测试病例。然后随机选取9422名20岁及以上无肺结核的受试者作为对照。病例组和对照组在性别、年龄和合并症方面进行了匹配。PPI的使用定义为在索引日期前至少有一次这些药物处方的受试者。未使用定义为在索引日期前从未有过PPI处方的受试者。使用逻辑回归模型估计与PPI使用相关的肺结核的比值比(OR)和95%置信区间(CI)。与未使用药物的受试者相比,使用PPI的受试者患肺结核的OR为1.31(95%CI 1.22,1.41)。亚分析显示,每增加微克使用PPI的受试者患肺结核的OR为1.25(95%CI 1.19,1.30)。在台湾,使用PPI会使患肺结核的几率增加1.3倍。PPI使用与肺结核之间存在剂量相关反应。

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