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氟喹诺酮类药物与主动脉瘤或主动脉夹层风险：一项全国性巢式病例对照研究及匹配实验模型的证据

Fluoroquinolones and the risk of aortic aneurysm or aortic dissection: evidence from a nationwide nested case-control study paralleled with matched experimental models.

作者信息

Wesley Callan D, Strange Jarl Emanuel, Holt Anders, Gislason Gunnar H, Neutel Cédric H G, Krüger Dustin N, Civati Celine, Theunis Mart, Naessens Tania, Roth Lynn, De Meyer Guido R Y, Martinet Wim, Rasmussen Peter Vibe, Guns Pieter-Jan

机构信息

Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences and Faculty of Pharmaceutical Biomedical and Veterinary Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, Antwerp 2610, Belgium.

Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 6, Hellerup 2900, Denmark.

出版信息

Eur Heart J Open. 2025 Mar 15;5(3):oeaf021. doi: 10.1093/ehjopen/oeaf021. eCollection 2025 May.

DOI:10.1093/ehjopen/oeaf021
PMID:40352252
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12062879/
Abstract

AIMS

Fluoroquinolones (FQ) have been associated with aortic aneurysm and aortic dissection (AA/AD) resulting in an official warning. Recently, large-scale epidemiological studies failed to confirm this.

METHODS AND RESULTS

The current study aimed to scrutinize the FQ-AA/AD association through a retrospective nested case-cohort analysis supplemented with animal experimentation. FQ exposure was not associated with increased AA/AD hazard ratios in main and high-risk (elderly ≥65 years, hypertensive, and prevalent aortic disease) populations. Additionally, FQ did not cause increased mortality or aortic interventions in aortic disease patients. In addition, in animal experimentation, ciprofloxacin did not enlarge aortic diameters nor increase arterial stiffness.

CONCLUSION

Conventional use of FQ should not be avoided when clinically indicated.

摘要

目的

氟喹诺酮类药物（FQ）与主动脉瘤和主动脉夹层（AA/AD）有关，因此发布了官方警告。最近，大规模流行病学研究未能证实这一点。

方法与结果

本研究旨在通过回顾性巢式病例对照分析并辅以动物实验，仔细研究FQ与AA/AD之间的关联。在主要人群和高危人群（年龄≥65岁的老年人、高血压患者和患有主动脉疾病者）中，接触FQ与AA/AD风险比增加无关。此外，FQ不会导致主动脉疾病患者的死亡率增加或主动脉干预增加。此外，在动物实验中，环丙沙星不会使主动脉直径增大，也不会增加动脉僵硬度。

结论

在有临床指征时，不应避免常规使用FQ。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/89992ca2e4c9/oeaf021f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/99f571691916/oeaf021_ga.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/b9cad649dd4a/oeaf021f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/59f234c7eaab/oeaf021f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/020b6a715db8/oeaf021f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/89992ca2e4c9/oeaf021f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/99f571691916/oeaf021_ga.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/eed7d7eb7dd7/oeaf021f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/b9cad649dd4a/oeaf021f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/59f234c7eaab/oeaf021f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/020b6a715db8/oeaf021f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2db/12062879/89992ca2e4c9/oeaf021f5.jpg

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Lack of association between fluoroquinolone and aortic aneurysm or dissection.氟喹诺酮与主动脉瘤或主动脉夹层之间无关联。
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Association Between Fluoroquinolone Use and Hospitalization With Aortic Aneurysm or Aortic Dissection.
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Effects of Age, Sex, and Extracellular Matrix Integrity on Aortic Dilatation and Rupture in a Mouse Model of Marfan Syndrome.年龄、性别和细胞外基质完整性对马凡综合征小鼠模型主动脉扩张和破裂的影响。
Arterioscler Thromb Vasc Biol. 2023 Sep;43(9):e358-e372. doi: 10.1161/ATVBAHA.123.319122. Epub 2023 Jul 20.
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