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组胺H2受体阻断药与阿尔茨海默病风险:鹿特丹研究

Histamine H2 blocking drugs and the risk for Alzheimer's disease: the Rotterdam Study.

作者信息

Launer L J, Jama J W, Ott A, Breteler M M, Hoes A W, Hofman A

机构信息

Department of Epidemiology & Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.

出版信息

Neurobiol Aging. 1997 Mar-Apr;18(2):257-9. doi: 10.1016/s0197-4580(97)00010-9.

Abstract

We investigated the cross-sectional relation of the use of histamine H2 blocking drugs and the risk for AD in the population based Rotterdam Study. AD was clinically diagnosed according to DSM-IIIR and NINCDS-ADRDA criteria. Data on medication used in the past week were obtained by having subjects show vials of medications and were classified according to the Anatomical Therapeutic Chemical (ATC) index. There were 7276 subjects with complete data, including 208 with AD and 378 H2 users (ATC code A0BA). Compared to the total cohort of non-H2 users, the relative risk (estimated as the odds ratio) for AD among those taking H2 blockers was 0.95 (95% confidence interval (CI) 0.52-1.75), after controlling for age, education, sex, history of stroke, and use of benzodiazepines and nonsteroidal antiinflammatory drugs. To address unmeasured confounding (by (contra) indication), we compared the risk of AD in H2 users with a subset of subjects using topical medications (ATC code D and S; n = 436). The adjusted OR in this comparison was 1.24 (95% CI 0.52-2.98). These results do not support the hypothesis that use of histamine H2 blocking drugs protect against AD.

摘要

在基于人群的鹿特丹研究中,我们调查了组胺H2阻断药物的使用与患阿尔茨海默病(AD)风险之间的横断面关系。AD根据《精神疾病诊断与统计手册第三版修订本》(DSM-IIIR)和美国国立神经疾病与中风研究所 - 阿尔茨海默病及相关疾病协会(NINCDS-ADRDA)标准进行临床诊断。通过让受试者展示药瓶来获取过去一周内使用药物的数据,并根据解剖学治疗化学(ATC)索引进行分类。共有7276名受试者拥有完整数据,其中包括208名AD患者和378名H2药物使用者(ATC代码A0BA)。在控制了年龄、教育程度、性别、中风病史以及苯二氮䓬类药物和非甾体抗炎药的使用情况后,与非H2药物使用者的总队列相比,服用H2阻断剂者患AD的相对风险(估计为比值比)为0.95(95%置信区间(CI)0.52 - 1.75)。为了解决未测量的混杂因素(通过(反)适应症),我们将H2药物使用者患AD的风险与使用局部用药的受试者子集(ATC代码D和S;n = 436)进行了比较。该比较中的调整后比值比为1.24(95%CI 0.52 - 2.98)。这些结果不支持组胺H2阻断药物可预防AD的假设。

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