Department of Emergency, Huashan Hospital, Fudan University, Shanghai, China.
Dis Markers. 2022 Jun 28;2022:4093595. doi: 10.1155/2022/4093595. eCollection 2022.
Proton pump inhibitors (PPIs) are commonly used to treat gastric acidity, and their frequent use may trigger various malfunctioning, such as cardiac, renal, and liver function failure. In the current study, we evaluated the association between the excessive use of the PPIs and the clinical complications of intensive care unit (ICU) septic patients.
A total of 208188 patients were analyzed from 2016 to 2017 through the China Critical Care Sepsis Trial (CCCST) database. The characteristics of the study group and outcome of events from the PPI- and H blocker-using groups were reported. To get unbiased results, the data from the target trials were randomly assigned for PPI and H blocker groups.
The data revealed 43.34 excess deaths (95% confidence intensive (CI) 25.12 to 62.02) per 1000 patients in patients extensively consuming PPI drugs. The sepsis with chronic kidney disease attributed to deaths 21.36; 95% CI (9.34 to 23.23). However, comorbidities, including circulatory diseases (16.34; 95% CI 5.78 to 23.45), nervous system (2.08; 95% CI 1.56 to 6.34), mental disorders (1.87; 95% CI 1.65 to 2.95), genitourinary system (5.23; 95% CI 3.69 to 8.89), and infectious and parasitic disease (4.17; 95% CI 1.44 to 7.49), were also reported. Extensive use of the PPIs and H blockers was associated with esophageal adenocarcinoma, Barrett's esophagus, neoplasms, and GI cancers.
We conclude that the excessive use of PPI in sepsis patients triggers chronic kidney disease which has a higher clinical complication rate among others.
质子泵抑制剂（PPIs）常用于治疗胃酸过多，其频繁使用可能会引发各种功能障碍，如心脏、肾脏和肝功能衰竭。在本研究中，我们评估了 PPI 过度使用与重症监护病房（ICU）脓毒症患者临床并发症之间的关系。
通过中国危重病脓毒症试验（CCCST）数据库，对 2016 年至 2017 年的 208188 例患者进行了分析。报告了 PPI 和 H2 受体阻滞剂使用组的研究组特征和事件结局。为了获得无偏结果，将目标试验的数据随机分配给 PPI 和 H2 受体阻滞剂组。
数据显示，在广泛使用 PPI 药物的患者中，每 1000 名患者中有 43.34 例额外死亡（95%置信区间（CI）25.12 至 62.02）。由慢性肾脏病引起的脓毒症导致死亡 21.36 例；95%CI（9.34 至 23.23）。然而，还报告了一些合并症，包括循环系统疾病（16.34；95%CI 5.78 至 23.45）、神经系统疾病（2.08；95%CI 1.56 至 6.34）、精神障碍（1.87；95%CI 1.65 至 2.95）、泌尿系统疾病（5.23；95%CI 3.69 至 8.89）和传染病和寄生虫病（4.17；95%CI 1.44 至 7.49）。PPIs 和 H2 受体阻滞剂的广泛使用与食管腺癌、巴雷特食管、肿瘤和胃肠道癌症有关。
我们的结论是，脓毒症患者中 PPI 的过度使用会引发慢性肾脏病，这会导致更高的临床并发症发生率。
