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目的 :检测选择性 5 羟色胺再摄取抑制剂与上消化道出血危险度之间的联系。设计 :以群体为基础的病例对照研究。背景 :英国全科医学研究数据库中的全科医学资料。对象 :1993年 4月～ 1997年 9月之间 ,年龄40岁～ 79岁的 16 5 1例上消化道出血病人和 2 48例溃疡穿孔病人 ,以及在年龄、性别和就诊年度上配对的 10 0 0 0名对照者。干预 :回顾所有可能进入研究的病人的计算机资料 ,并在回顾计算机信息的基础上 ,进行一项内部的有效性研究 ,以证实诊断的准确性。主要观测指标 :在标记日之前的 30天内 ,目前用选择性 5 羟色胺再摄取抑制剂或其他抗抑郁药的情况。结果 :目前暴露于选择性 5 羟色胺再摄取抑制剂病人 ,上消化道出血率为 3.1% (5 2 / 16 5 1) ,对照者只有 1.0 % (95 / 10 0 0 0 ) ,校正率比为 3.0(95 %可信区间 2 .1～ 4.4)。该指标未按性别、年龄、药物剂量或治疗周期进行校正 ,估计粗发病率为 1例 / 80 0 0张处方。非选择性 5 羟色胺再摄取抑制剂与上消化道出血之间有较弱的联系 (相对危险度 1.4,1.1～ 1.9)。与缺乏这种抑制作用的抗抑郁药之间则没有联系。几类抗抑郁药与溃疡穿孔均无联系。同时用选择性 5 羟色胺摄取抑制剂和非甾体抗炎药 ,增加上消化道出血危险度 ,并超过了它们各自作用?
PURPOSE: To examine the link between selective serotonin reuptake inhibitors and the risk of upper gastrointestinal bleeding. Design: A population-based case-control study. Background: General practice data in the UK General Practice Research Database. PARTICIPANTS: A total of 1651 patients with upper gastrointestinal bleeding aged from 40 to 79 years old and 248 patients with ulcer perforation between April 1993 and September 1997 were selected and matched for age, sex and year of treatment 0 0 respondents. Intervention: A review of the computerized data of all patients who may be entering the study. Based on computer information, an internal validation study was conducted to confirm the accuracy of the diagnosis. MAIN OUTCOME MEASURES: Current status of reuptake of inhibitors or other antidepressants with selective serotonin within 30 days prior to the labeling date. Results: The patients who were exposed to selective inhibitors of serotonin reuptake had a rate of upper gastrointestinal bleeding of 3.1% (5 2/165 1) and only 1.0% (95/10 000) in control subjects, with a correction rate of 3.0 (95% confidence interval 2.1-1.4). The index was not adjusted by sex, age, drug dose or treatment cycle, the crude incidence was estimated to be 1 case / 80 0 prescriptions. Non-selective serotonin reuptake inhibitors and upper gastrointestinal bleeding have a weak link (relative risk 1.4,1.1 ~ 1.9). There is no link between antidepressants that lack this inhibitory effect. Several types of antidepressants and ulcer perforation were not linked. At the same time with selective serotonin uptake inhibitors and non-steroidal anti-inflammatory drugs to increase the risk of upper gastrointestinal bleeding, and more than their respective role?