Department of Public Health, College of Public Health, and School of Medicine, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
College of Medicine, Tzu Chi University, Hualien, Taiwan, Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taichung, Taiwan.
Medicine (Baltimore). 2023 Feb 3;102(5):e32779. doi: 10.1097/MD.0000000000032779.
Epidemiological studies have shown that people having hyperuricemia are at increased risk of ischemic cerebrovascular disease. This research aimed to study the relation of ischemic cerebrovascular disease with benzbromarone use among persons with gout-related disorders. This was a retrospective cohort design utilizing a 2003 to 2015 national health insurance database in Taiwan. Subjects aged 20 to 99 years who already had suffered from gout-related disorders were included as eligible subjects. Eligible persons who had the benzbromarone prescription alone were selected into the benzbromarone group. Sex-matched and age-matched eligible persons who never used any urate-lowering agents were selected into the control group. An index date was set as a date of benzbromarone being prescribed. The end-point was defined as ischemic cerebrovascular disease being newly diagnosed. A hazard ratio was applied to measure the association strength between benzbromarone use and ischemic cerebrovascular disease. Totally, there were 13,398 persons in the benzbromarone group and 13,398 persons in the control group. The incidence rate of ischemic cerebrovascular disease seemed to be modestly higher in the benzbromarone group than the control group, but it did not achieve statistical significance (0.78 vs 0.75 every 100 person-years, incidence rate ratio = 1.05, 95% confidence interval = 0.94-1.16). A crude hazard ratio of ischemic cerebrovascular disease showed 1.05 in the benzbromarone group (95% confidence interval = 0.94-1.17, P = .373) comparing with the control group. No significant association can be detected between benzbromarone use and the probability of ischemic cerebrovascular disease among persons with gout-related disorders. We think that reduction of the serum uric acid by use of benzbromarone could not be related to the probability of ischemic cerebrovascular disease. Further research is suggested to clarify this issue.
流行病学研究表明，高尿酸血症患者发生缺血性脑血管病的风险增加。本研究旨在探讨苯溴马隆在痛风相关疾病患者中的应用与缺血性脑血管病的关系。这是一项利用台湾 2003 年至 2015 年国家健康保险数据库的回顾性队列设计研究。纳入的合格受试者为已患有痛风相关疾病且年龄在 20 至 99 岁之间的人群。选择仅接受苯溴马隆处方的合格者为苯溴马隆组。选择性别和年龄匹配且从未使用过任何尿酸降低剂的合格者为对照组。将索引日期设定为开具苯溴马隆的日期。终点定义为新诊断出缺血性脑血管病。应用风险比来衡量苯溴马隆使用与缺血性脑血管病之间的关联强度。共有 13398 名患者进入苯溴马隆组，13398 名患者进入对照组。苯溴马隆组缺血性脑血管病的发生率似乎略高于对照组，但无统计学意义（0.78 比 0.75 每 100 人年，发病率比 = 1.05，95%置信区间 = 0.94-1.16）。苯溴马隆组缺血性脑血管病的粗风险比为 1.05（95%置信区间 = 0.94-1.17，P =.373），与对照组相比。在痛风相关疾病患者中，苯溴马隆的使用与缺血性脑血管病的概率之间未发现显著关联。我们认为，使用苯溴马隆降低血清尿酸水平与缺血性脑血管病的概率无关。建议进一步研究以阐明这个问题。
