老年患者使用别嘌醇与白内障摘除风险

Exposure to allopurinol and the risk of cataract extraction in elderly patients.

作者信息

Garbe E, Suissa S, LeLorier J

机构信息

Potsdam Institute of Pharmacoepidemiology and Technology Assessment, Germany.

出版信息

Arch Ophthalmol. 1998 Dec;116(12):1652-6. doi: 10.1001/archopht.116.12.1652.

DOI:10.1001/archopht.116.12.1652

PMID:9869797

Abstract

OBJECTIVE

To determine whether exposure to allopurinol is associated with an increased risk of cataract extraction in elderly patients.

METHODS

We conducted a case-control study using data from the Quebec universal health insurance program for all elderly patients. The 3677 cases were patients with a cataract extraction between 1992 and 1994. The 21,868 controls were randomly selected among patients not diagnosed with cataract and matched to cases on the date of the extraction. We determined the odds ratio of cataract extraction according to the cumulative dose and duration of allopurinol use relative to nonusers, using conditional logistic regression analysis. The analysis was adjusted for the effects of age, sex, diabetes mellitus, hypertension, glaucoma, and ophthalmic and oral corticosteroid exposure.

RESULTS

A cumulative dose of allopurinol of more than 400 g or a duration of use of longer than 3 years were associated with an increased risk of cataract extraction, with odds ratios of 1.82 (95% confidence interval [CI], 1.18-2.80) and 1.53 (95% CI, 1.12-2.08), respectively. No increase in risk was observed for lower cumulative doses or shorter exposure periods.

CONCLUSION

Long-term administration of allopurinol increases the risk of cataract extraction in elderly patients.

摘要

目的

确定老年患者使用别嘌醇是否会增加白内障摘除术的风险。

方法

我们利用魁北克全民医疗保险计划中所有老年患者的数据进行了一项病例对照研究。3677例病例为1992年至1994年间接受白内障摘除术的患者。21868名对照是从未被诊断为白内障的患者中随机选取的，并与病例在摘除日期上进行匹配。我们使用条件逻辑回归分析，根据别嘌醇使用的累积剂量和持续时间，相对于未使用者，确定白内障摘除术的比值比。分析针对年龄、性别、糖尿病、高血压、青光眼以及眼部和口服糖皮质激素暴露的影响进行了调整。