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质子泵抑制剂的使用与淋巴瘤患者中性粒细胞减少性发热的发展有关。

Association of proton pump inhibitor use with the development of febrile neutropenia in lymphoma patients.

机构信息

Liver Unit, Haemek Medical Center, Afula, Israel.

Nephrology Unit, Haemek Medical Center, Afula, Israel.

出版信息

Expert Rev Hematol. 2021 May;14(5):503-507. doi: 10.1080/17474086.2021.1920011. Epub 2021 Apr 26.

Abstract

: Proton pump inhibitors (PPIs), although relatively safe drugs for reduction of gastric acid production, continue to raise concerns (i.e. potential infectious complications, electrolyte disturbances). PPIs are frequently administered to hemato-oncological patients receiving chemotherapy. The study main objective is to investigate whether PPI use by hemato-oncological patients receiving chemotherapy raises the risk of febrile neutropenia.: This is a retrospective database study of patients under hemato-oncological follow up between January 2007 and December 2015, treated with different chemotherapy regimens. Comparative analysis assessed frequencies and types of febrile neutropenia among patients with or without PPI treatment. Multivariate analyses were performed adjusting for age, sub-type of malignancy and specific PPI administered.: 247 patients were included, 18-91 years of age (mean 61.6 ± 16), 120 (48.58%) female; amongst 66 (26%) how were hospitalized for febrile neutropenia, 50 (75.8%) received PPIs.Multivariate analysis found three risk factors associated with the development of febrile neutropenia in hematological patients: age, diffuse large B-cell lymphoma and treatment with PPIs.: A statistically significant association was demonstrated between PPI treatment and the development of febrile neutropenia among hemato-oncological patients. The clinical implications necessitate further caution in administering PPIs to patients with hematological malignancy receiving chemotherapy.

摘要

质子泵抑制剂 (PPIs) 虽然是一种相对安全的胃酸生成抑制剂,但仍存在一些问题(如潜在的感染并发症、电解质紊乱)。PPI 常被用于接受化疗的血液肿瘤患者。本研究的主要目的是探讨血液肿瘤患者在接受化疗时使用 PPI 是否会增加发热性中性粒细胞减少症的风险。

这是一项回顾性数据库研究,纳入了 2007 年 1 月至 2015 年 12 月期间接受不同化疗方案治疗的血液肿瘤患者。通过比较分析,评估了使用或未使用 PPI 的患者中发热性中性粒细胞减少症的发生频率和类型。通过多变量分析,调整了年龄、恶性肿瘤亚型和使用的特定 PPI 等因素。

共纳入 247 例患者,年龄 18-91 岁(平均 61.6 ± 16 岁),女性 120 例(48.58%);66 例(26%)因发热性中性粒细胞减少症住院,其中 50 例(75.8%)使用了 PPI。多变量分析发现,血液系统恶性肿瘤患者发生发热性中性粒细胞减少症的三个危险因素为:年龄、弥漫性大 B 细胞淋巴瘤和 PPI 治疗。

研究表明,PPI 治疗与血液肿瘤患者发热性中性粒细胞减少症的发生之间存在统计学显著关联。这一临床发现需要在为接受化疗的血液恶性肿瘤患者使用 PPI 时更加谨慎。

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