Department of Nursing, Mackay Medical College, New Taipei City, Taiwan.
Department of Community Psychiatry, Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan.
Pulmonology. 2024 Nov-Dec;30(6):577-585. doi: 10.1016/j.pulmoe.2023.01.003. Epub 2023 Mar 10.
Methamphetamine causes considerable short- and long-term adverse health effects. Our aim was to assess the effects of methamphetamine use on pulmonary hypertension and lung diseases at the population level.
This population-based retrospective study used data from the Taiwan National Health Insurance Research Database between 2000 and 2018 that included 18,118 individuals with methamphetamine use disorder (MUD) and 90,590 matched participants of the same age and sex without substance use disorder as the non-exposed group. A conditional logistic regression model was used to estimate associations of methamphetamine use with pulmonary hypertension and lung diseases such as lung abscess, empyema, pneumonia, emphysema, pleurisy, pneumothorax, or pulmonary hemorrhage. Incidence rate ratios (IRRs) of pulmonary hypertension and hospitalization due to lung diseases were determined between the methamphetamine group and non-methamphetamine group using negative binomial regression models.
During an 8-year observation period, 32 (0.2%) individuals with MUD and 66 (0.1%) non-methamphetamine participants suffered from pulmonary hypertension, and 2652 (14.6%) individuals with MUD and 6157 (6.8%) non-methamphetamine participants suffered from lung diseases. After adjusting for demographic characteristics and comorbidities, individuals with MUD were 1.78 times (95% confidence interval (CI) = 1.07-2.95) more likely to have pulmonary hypertension and 1.98 times (95% CI = 1.88-2.08) more likely to have a lung disease, especially emphysema, lung abscess, and pneumonia in descending order. Furthermore, compared to the non-methamphetamine group, the methamphetamine group was associated with higher risks of hospitalization caused by pulmonary hypertension and lung diseases. The respective IRRs were 2.79 and 1.67. Individuals with polysubstance use disorder were associated with higher risks of empyema, lung abscess, and pneumonia compared to individuals with MUD alone, with respective adjusted odds ratios of 2.96, 2.21, and 1.67. However, pulmonary hypertension and emphysema did not differ significantly between MUD individuals with or without polysubstance use disorder.
Individuals with MUD were associated with higher risks of pulmonary hypertension and lung diseases. Clinicians need to ensure that a methamphetamine exposure history is obtained as part of the workup for these pulmonary diseases and provide timely management for this contributing factor.
甲基苯丙胺会导致相当多的短期和长期不良健康影响。我们的目的是评估人群中使用甲基苯丙胺对肺动脉高压和肺部疾病的影响。
这项基于人群的回顾性研究使用了 2000 年至 2018 年期间来自台湾全民健康保险研究数据库的数据，其中包括 18118 名患有甲基苯丙胺使用障碍（MUD）的个体和 90590 名年龄和性别相匹配的没有物质使用障碍的个体作为非暴露组。使用条件逻辑回归模型来估计甲基苯丙胺使用与肺动脉高压和肺部疾病（如肺脓肿、脓胸、肺炎、肺气肿、胸膜炎、气胸或肺出血）之间的关联。使用负二项式回归模型确定甲基苯丙胺组和非甲基苯丙胺组之间肺动脉高压和因肺部疾病住院的发生率比（IRR）。
在 8 年的观察期内，32 名（0.2%）MUD 患者和 66 名（0.1%）非甲基苯丙胺参与者患有肺动脉高压，2652 名（14.6%）MUD 患者和 6157 名（6.8%）非甲基苯丙胺参与者患有肺部疾病。在调整人口统计学特征和合并症后，MUD 患者患肺动脉高压的可能性是未使用甲基苯丙胺患者的 1.78 倍（95%置信区间[CI]：1.07-2.95），患肺部疾病的可能性是未使用甲基苯丙胺患者的 1.98 倍（95%CI：1.88-2.08），尤其是肺气肿、肺脓肿和肺炎。此外，与非甲基苯丙胺组相比，甲基苯丙胺组与肺动脉高压和肺部疾病住院风险增加相关。相应的调整后发病率比（IRR）分别为 2.79 和 1.67。与单独使用 MUD 的个体相比，多药物使用障碍的个体与脓胸、肺脓肿和肺炎的风险更高，相应的调整后比值比分别为 2.96、2.21 和 1.67。然而，MUD 个体中是否存在多药物使用障碍与肺动脉高压和肺气肿之间无显著差异。
MUD 患者患肺动脉高压和肺部疾病的风险较高。临床医生需要确保在这些肺部疾病的评估中获得甲基苯丙胺暴露史，并为该致病因素提供及时的管理。
