Delcroix M, Kurz X, Walckiers D, Demedts M, Naeije R
Dept of Pneumology, Gasthuisberg University Hospital, Leuven, Belgium.
Eur Respir J. 1998 Aug;12(2):271-6. doi: 10.1183/09031936.98.12020271.
Primary pulmonary hypertension is a rare, progressive and incurable disease, which has been associated with the intake of appetite suppressant drugs. The importance of this association was evaluated in Belgium while this country still had no restriction on the prescription of appetite suppressants. Thirty-five patients with primary pulmonary hypertension and 85 matched controls were recruited over 32 months (1992-1994) in Belgium. Exposure to appetite-suppressants was assessed on the basis of hospital records and standardized interview. Twenty-three of the patients had previously taken appetite suppressants, mainly fenfluramines, as compared with only 5 of the controls (66 versus 6%, p<0.0001). Five patients died before the interview, all of them had taken appetite suppressants. In 8 patients the diagnosis of primary pulmonary hypertension was uncertain, 5 of them had taken appetite suppressants. The patients who had been exposed to appetite suppressants tended to be on average more severely ill, and to have a shorter median delay between onset of symptoms and diagnosis. A policy of unrestricted prescription of appetite suppressants may lead to a high incidence of associated primary pulmonary hypertension. Intake of appetite suppressants may accelerate the progression of the disease.
原发性肺动脉高压是一种罕见、进行性且无法治愈的疾病，它与食欲抑制剂药物的摄入有关。在比利时对这种关联的重要性进行了评估，当时该国对食欲抑制剂的处方仍没有限制。在1992年至1994年的32个月期间，比利时招募了35例原发性肺动脉高压患者和85例匹配的对照。根据医院记录和标准化访谈评估食欲抑制剂的暴露情况。23例患者之前服用过食欲抑制剂，主要是芬氟拉明，而对照组只有5例（66%对6%，p<0.0001）。5例患者在访谈前死亡，他们都服用过食欲抑制剂。在8例原发性肺动脉高压诊断不确定的患者中，5例服用过食欲抑制剂。暴露于食欲抑制剂的患者平均病情往往更严重，症状出现到诊断之间的中位延迟时间更短。食欲抑制剂的无限制处方政策可能导致相关原发性肺动脉高压的高发病率。服用食欲抑制剂可能会加速疾病的进展。
