Smalley W E, Ray W A, Daugherty J R, Griffin M R
Department of Medicine, Department of Veteran Affairs Medical Center, Vanderbilt University, Nashville, TN, USA.
Am J Epidemiol. 1998 Aug 15;148(4):350-4. doi: 10.1093/oxfordjournals.aje.a009652.
Calcium channel antagonists are commonly used drugs that have recently been reported to be associated with an increased incidence of gastrointestinal hemorrhage. We performed a retrospective cohort study among 105,824 enrollees of the Tennessee Medicaid program 65 years of age or older between 1984 and 1986. Exposure to calcium channel blockers and other medications was determined from pharmacy files. Hospitalization for bleeding peptic ulcers was identified by hospital claims and verified by a review of the medical record. Univariate estimates of relative risk for current users of calcium channel blockers and beta-blocker users were 1.8 (95% confidence interval (CI) 1.2-2.7) and 1.1 (95% CI 0.7-1.6) (reference group was nonuse of either). After adjustment for potential confounders, the relative risks for bleeding peptic ulcer among current users of calcium channel blockers and beta blockers were 1.1 (95% CI 0.7-1.7) and 1.0 (95% CI 0.7-1.6), respectively, when compared with those who used neither drug. In this population, after controlling for important confounders, there was no increased risk for hospitalization with bleeding peptic ulcer among users of calcium channel blockers.
钙通道拮抗剂是常用药物,最近有报道称其与胃肠道出血发生率增加有关。我们对1984年至1986年间田纳西医疗补助计划中105824名65岁及以上的参保者进行了一项回顾性队列研究。通过药房档案确定钙通道阻滞剂和其他药物的使用情况。通过医院理赔记录识别出血性消化性溃疡住院病例,并通过病历审查进行核实。钙通道阻滞剂当前使用者和β受体阻滞剂使用者的相对风险单变量估计值分别为1.8(95%置信区间[CI] 1.2 - 2.7)和1.1(95% CI 0.7 - 1.6)(参照组为两种药物均未使用)。在对潜在混杂因素进行调整后,与两种药物都未使用的人相比,钙通道阻滞剂当前使用者和β受体阻滞剂使用者发生出血性消化性溃疡的相对风险分别为1.1(95% CI 0.7 - 1.7)和1.0(95% CI 0.7 - 1.6)。在该人群中,在控制了重要混杂因素后,钙通道阻滞剂使用者因出血性消化性溃疡住院的风险并未增加。