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老年人使用质子泵抑制剂:权衡风险与获益——一个由来已久的问题

Proton Pump Inhibitors in the Elderly, Balancing Risk and Benefit: an Age-Old Problem.

作者信息

Kanno Takeshi, Moayyedi Paul

机构信息

Farncombe Family Digestive Health Research Institute, McMaster University, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5, Canada.

出版信息

Curr Gastroenterol Rep. 2019 Dec 5;21(12):65. doi: 10.1007/s11894-019-0732-3.

Abstract

PURPOSE OF REVIEW

Proton pump inhibitors (PPIs) are one of the most prescribed drugs in the developed world and elderly patients are particularly likely to be prescribed acid suppression. There have been reports of many diseases being associated with PPI therapy and the elderly would be particular at risk of any harms these drugs may cause. This review therefore reviews the evidence of the risks and benefits of these drugs.

RECENT FINDINGS

PPIs are very effective at treating acid-related disorders. Recent randomized trials have suggested that the associations between PPI and various diseases are likely to be related to bias and residual confounding and these drugs appear to be safe apart from a possible increase risk of enteric infections. PPIs should be used at the lowest dose and for the shortest duration possible. They are still relatively safe drugs but should only be prescribed for proven indications.

摘要

综述目的

质子泵抑制剂(PPIs)是发达国家处方量最大的药物之一,老年患者尤其可能被处方使用抑酸药物。有许多疾病与PPI治疗相关的报道,老年人尤其容易受到这些药物可能造成的任何危害。因此,本综述回顾了这些药物风险和益处的证据。

最新发现

PPI在治疗酸相关疾病方面非常有效。近期的随机试验表明,PPI与各种疾病之间的关联可能与偏倚和残余混杂因素有关,除了可能增加肠道感染风险外,这些药物似乎是安全的。PPI应使用最低剂量并尽可能缩短疗程。它们仍然是相对安全的药物,但仅应在有明确适应症时处方使用。

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