论文部分内容阅读
目的由于抗抑郁药可影响血液中5-羟色胺水平,故该类药物的使用可能与异常出血风险的增加有关。然而,以前的研究在这方面并没有确切的结论。本研究旨在评价抗抑郁药的使用与异常出血风险的关系,并确立5-羟色胺再摄取抑制程度与出血风险的相关性。方法本研究的数据来自1992￣2000年一项巢式病例对照研究,该队列研究有64000余名首次接受抗抑郁药治疗的患者。对初步诊断为异常出血的入院患者进行了分类,并根据年龄、性别进行配对。本研究根据5-羟色胺再吸收的抑制程度(高、中、低)予以分类,并通过对数回归分析计算相对风险(oddsratios)。结果异常出血病例共计196例。使用中度(相对风险为1.9;95%可信限为1.3￣3.5)、高度(相对风险2.6;95%可信限为1.4￣4.8)5-羟色胺再吸收抑制剂后,入院风险有所增加。结论在大样本量的首次接受抗抑郁药治疗的人群中,发现抗抑郁药对5-羟色胺再吸收抑制程度与医院初步诊断为异常出血的入院病例之间具有明显的相关性。异常出血风险增加与5-羟色胺抑制程度密切相关。
Purpose Since antidepressants can affect serotonin levels in the blood, the use of these drugs may be associated with an increased risk of abnormal bleeding. However, previous studies have not been conclusive in this respect. The aim of this study was to evaluate the relationship between the use of antidepressants and the risk of abnormal bleeding and to establish the correlation between the extent of inhibition of serotonin reuptake and the risk of bleeding. Methods The data from this study were from a nested case-control study from 1992 to 2000 with 64,000 first-time antidepressant-treated patients. Admitted patients who were initially diagnosed as having abnormal bleeding were classified and matched according to age and sex. This study classifies the extent of serotonin reuptake inhibition (high, medium, and low) and calculates oddsratios by log-linear regression analysis. Results A total of 196 cases of abnormal bleeding. There was an increased risk of admission after moderate (relative risk 1.9; 95% confidence limit 1.3 to 3.5) and height (relative risk 2.6; 95% confidence limit 1.4 to 4.8) serotonin reuptake inhibitors . Conclusions In a large sample of first-time antidepressants, there was a clear correlation between the degree of inhibition of serotonin reuptake by antidepressants and hospital admission of patients initially diagnosed as having abnormal bleeding. The increased risk of abnormal bleeding is closely related to the degree of inhibition of serotonin.