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长期使用苯二氮䓬类药物者患痴呆症的风险:来自观察性研究的荟萃分析证据

Risk of Dementia in Long-Term Benzodiazepine Users: Evidence from a Meta-Analysis of Observational Studies.

作者信息

He Qian, Chen Xiaohua, Wu Tang, Li Liyuan, Fei Xiaofan

机构信息

Department of Out-Patient, West China Hospital, Sichuan Uniwersity, Chengdu, China.

Department of Nursing, West China Hospital, Sichuan Uniwersity, Chengdu, China.

出版信息

J Clin Neurol. 2019 Jan;15(1):9-19. doi: 10.3988/jcn.2019.15.1.9. Epub 2018 Oct 26.

Abstract

BACKGROUND AND PURPOSE

There is conflicting evidence in the literature on the association between benzodiazepines (BDZs) and the risk of dementia. This meta-analysis aimed to determine the relationship between the long-term usage of BDZs and the risk of dementia.

METHODS

The PubMed and Embase databases were systematically searched for relevant publications up to September 2017. The literature search focused on observational studies that analyzed the relationship between the long-term use of BDZs and the risk of dementia. Pooled rate ratios (RRs) with 95% confidence interval (CI) were assessed using a random-effects model. The robustness of the results was checked by performing subgroup and sensitivity analyses.

RESULTS

Ten studies were included: six case-control and four cohort studies. The pooled RR for developing dementia was 1.51 (95% CI=1.17-1.95, =0.002) in patients taking BDZ. The risk of dementia was higher in patients taking BDZs with a longer half-life (RR=1.16, 95% CI=0.95-1.41, =0.150) and for a longer time (RR=1.21, 95% CI=1.04-1.40, =0.016).

CONCLUSIONS

This meta-analysis that pooled ten studies has shown that BDZ significantly increases the risk of dementia in the elderly population. The risk is higher in patients taking BDZ with a longer half-life (>20 hours) and for a longer duration (>3 years).

摘要

背景与目的

关于苯二氮䓬类药物(BDZs)与痴呆风险之间的关联,文献中的证据存在冲突。本荟萃分析旨在确定BDZs的长期使用与痴呆风险之间的关系。

方法

系统检索PubMed和Embase数据库,查找截至2017年9月的相关出版物。文献检索聚焦于分析BDZs长期使用与痴呆风险之间关系的观察性研究。采用随机效应模型评估合并率比(RRs)及95%置信区间(CI)。通过进行亚组分析和敏感性分析来检验结果的稳健性。

结果

纳入10项研究:6项病例对照研究和4项队列研究。服用BDZ的患者发生痴呆的合并RR为1.51(95%CI=1.17-1.95,P=0.002)。服用半衰期较长(RR=1.16,95%CI=0.95-1.41,P=0.150)和服用时间较长(RR=1.21,95%CI=1.04-1.40,P=0.016)的BDZs的患者患痴呆风险更高。

结论

这项汇总了10项研究的荟萃分析表明,BDZ显著增加老年人群患痴呆的风险。服用半衰期较长(>20小时)和服用持续时间较长(>3年)的BDZ的患者风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ace/6325366/c54012855f94/jcn-15-9-g001.jpg

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