Lai Shih-Wei, Lin Hsien-Feng, Lin Cheng-Li, Liao Kuan-Fu
College of Medicine, China Medical University, Taichung, Taiwan.
Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
Eur J Hosp Pharm. 2017 Mar;24(2):120-123. doi: 10.1136/ejhpharm-2015-000840. Epub 2016 May 5.
Clinical evidence is scarce about the relationship between losartan use and acute pancreatitis. We therefore conducted a population-based case-control study using the database from the Taiwan National Health Insurance Program to investigate this question.
The study consisted of 1449 hypertensive subjects aged 20-84 years with a first episode of acute pancreatitis during the period 2000-2011 as the case group and 2479 hypertensive subjects without acute pancreatitis as the control group. Both the case and control groups were matched for sex, age, comorbidities and index year of acute pancreatitis diagnosis. According to the history of losartan prescription before the date of diagnosis of acute pancreatitis, subjects who had never received a prescription for losartan were defined as 'never use of losartan', those whose last remaining losartan tablet was detected within 7 days before the date of diagnosis of acute pancreatitis were defined as 'current use of losartan' and those whose last remaining tablet of losartan was detected ≥8 days before the date of diagnosis of acute pancreatitis were defined as 'late use of losartan'. ORs and 95% CIs were measured to investigate the risk of acute pancreatitis associated with losartan use by the multivariable unconditional logistic regression model.
After adjustment for potentially confounding factors, the adjusted OR of acute pancreatitis was 0.96 (95% CI 0.68 to 1.37) for subjects with current use of losartan compared with those with never use of losartan, but the difference was not statistically significant. For subjects with late use of losartan the adjusted OR of acute pancreatitis was 1.05 (95% CI 0.80 to 1.37), which also was not statistically significant.
No significant association can be detected between losartan use and acute pancreatitis in hypertensive patients. More research is required to determine the potential role of losartan in the risk of acute pancreatitis.
关于使用氯沙坦与急性胰腺炎之间的关系，临床证据较少。因此，我们利用台湾全民健康保险计划的数据库开展了一项基于人群的病例对照研究，以探讨这一问题。
该研究包括1449名年龄在20 - 84岁之间、在2000年至2011年期间首次发生急性胰腺炎的高血压患者作为病例组，以及2479名无急性胰腺炎的高血压患者作为对照组。病例组和对照组在性别、年龄、合并症以及急性胰腺炎诊断的索引年份方面进行了匹配。根据急性胰腺炎诊断日期之前的氯沙坦处方史，从未接受过氯沙坦处方的受试者被定义为“从未使用氯沙坦”，在急性胰腺炎诊断日期前7天内检测到最后剩余氯沙坦片的受试者被定义为“当前使用氯沙坦”，而在急性胰腺炎诊断日期前≥8天检测到最后剩余氯沙坦片的受试者被定义为“延迟使用氯沙坦”。通过多变量无条件逻辑回归模型测量比值比（OR）和95%可信区间（CI），以研究使用氯沙坦与急性胰腺炎相关的风险。
在对潜在混杂因素进行调整后，当前使用氯沙坦的受试者与从未使用氯沙坦的受试者相比，急性胰腺炎的调整后OR为0.96（95%CI为0.68至1.37），但差异无统计学意义。对于延迟使用氯沙坦的受试者，急性胰腺炎的调整后OR为1.05（95%CI为0.80至1.37），同样无统计学意义。
在高血压患者中，未检测到使用氯沙坦与急性胰腺炎之间存在显著关联。需要更多研究来确定氯沙坦在急性胰腺炎风险中的潜在作用。
