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类固醇对阿尔茨海默病痴呆进展的影响:一项回顾性病历审查

Effect of Steroids on the Progression of Alzheimer's Dementia: A Retrospective Chart Review.

作者信息

Conic Julijana Zoran, Chetty Alexandra, Chen Lily, Marsh Audrey, Barry Sean, Pattabhi Rodney, Reske Thomas, Aguilar Erwin, Ali Lobna

机构信息

Section of Geriatric Medicine, Department of Internal Medicine, LSU Health Sciences Center School of Medicine in New Orleans New Orleans Louisiana USA.

Section of General Internal Medicine, Department of Internal Medicine, LSU Health Sciences Center School of Medicine in New Orleans New Orleans Louisiana USA.

出版信息

Aging Med (Milton). 2025 Feb 18;8(1):e70004. doi: 10.1002/agm2.70004. eCollection 2025 Feb.

Abstract

OBJECTIVES

Alzheimer's disease (AD) is a prevalent age-related neurodegenerative disease that affects millions of individuals in the United States. Neuroinflammation is a driver of the neurodegenerative changes that characterize AD, prompting interest in how inflammation can be modulated for treatment and prevention.

METHODS

ICD-10 codes were quarried from electronic medical records to identify patients diagnosed with AD from 2012 to 2020. The patients were then divided into those who used systemic steroids and those who did not before the progression of their disease. Data on medication prescribed was used to measure the disease's progression. Clinical findings and laboratory results were collected to build a propensity score. Patients were followed until disease progression, death, or the last available visit. Kaplan-Meier curves and hazard ratios adjusted for the propensity score were used to compare the two groups.

RESULTS

Of the 459 patients identified, 77 were included in the study, and 13 used steroids. Of the 77 patients included in the study, 59 had progression of their disease, and of those, five used steroids. The median time to progression was 408.00 (191.00, 979.00) days for the overall sample. The hazard ratio (HR) comparing the group using steroids to those not using steroids was 0.26 with a 95% CI of (0.1013, 0.673) and a  value of 0.00064.

CONCLUSIONS

In our study, steroid use delayed the progression of dementia. Further study is needed to outline how steroids and anti-inflammatory medications can be used in the treatment and prevention of AD.

摘要

目的

阿尔茨海默病(AD)是一种常见的与年龄相关的神经退行性疾病,在美国影响着数百万个体。神经炎症是AD特征性神经退行性变化的驱动因素,这引发了人们对如何调节炎症以进行治疗和预防的兴趣。

方法

从电子病历中提取国际疾病分类第十版(ICD - 10)编码,以识别2012年至2020年期间被诊断为AD的患者。然后将患者分为在疾病进展前使用全身类固醇的患者和未使用全身类固醇的患者。使用所开药物的数据来衡量疾病的进展。收集临床发现和实验室结果以建立倾向评分。对患者进行随访,直至疾病进展、死亡或最后一次可获得的就诊。使用根据倾向评分调整的Kaplan - Meier曲线和风险比来比较两组。

结果

在识别出的459名患者中,77名被纳入研究,其中13名使用了类固醇。在纳入研究的77名患者中,59名疾病出现进展,其中5名使用了类固醇。整个样本进展的中位时间为408.00(191.00,979.00)天。使用类固醇的组与未使用类固醇的组相比,风险比(HR)为0.26,95%置信区间为(0.1013,0.673),P值为0.00064。

结论

在我们的研究中,使用类固醇延缓了痴呆的进展。需要进一步研究来阐明类固醇和抗炎药物如何用于AD的治疗和预防。

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