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[大学生论坛]:抗生素药物

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lahuanjin 发表于 2017-12-30 20:09:50 | 显示全部楼层 |阅读模式
Abstract
摘要

Importance  
Antithrombotic medications are among the most commonly prescribed medications.
重要性
抗生素药物是最为常用的药物
Objective  
To characterize rates of hematuria-related complications among patients taking antithrombotic medications.
目标
确认服用抗生素患者所患血尿并发症等级
Design, Setting, and Participants
Population-based, retrospective cohort study including all citizens in Ontario, Canada, aged 66 years and older between 2002 and 2014. The final follow-up date was December 31, 2014.
实验组设计,设置和受试者
以人口为基础,回顾群组调查包括加拿大的安大略省所有居民,在2002年和2014年之间受试者的年龄为66岁以上。最后的随访日期为20141231日。

Exposures  
Receipt of an oral anticoagulant or antiplatelet medication.
曝光量
接收可口服的抗凝血剂或抗血小板剂治疗

Main Outcomes and Measures  
Hematuria-related complications, defined as emergency department visit, hospitalization, or a urologic procedure to investigate or manage gross hematuria.
主要结果和方法
与血尿相关的并发症被确诊为需急诊治疗,住院治疗或需进行调查或者控制总血尿的泌尿过程。

Results  
Among 2 518 064 patients, 808 897 (mean [SD] age, 72.1 [6.8] years; 428 531 [53%] women) received at least 1 prescription for an antithrombotic agent over the study period. Over a median follow-up of 7.3 years, the rates of hematuria-related complications were 123.95 events per 1000 person-years among patients actively exposed to antithrombotic agents vs 80.17 events per 1000 person-years among patients not exposed to these drugs (difference, 43.8; 95% CI, 43.0-44.6; P < .001, and incidence rate ratio [IRR], 1.44; 95% CI, 1.42-1.46). The rates of complications among exposed vs unexposed patients (80.17 events/1000 person-years) were 105.78 for urologic procedures (difference, 33.5; 95% CI, 32.8-34.3; P < .001, and IRR, 1.37; 95% CI, 1.36-1.39), 11.12 for hospitalizations (difference, 5.7; 95% CI, 5.5-5.9; P < .001, and IRR, 2.03; 95% CI, 2.00-2.06), and 7.05 for emergency department visits (difference, 4.5; 95% CI, 4.3-4.7; P < .001, and IRR, 2.80; 95% CI, 2.74-2.86). Compared with patients who were unexposed to thrombotic agents, the rates of hematuria-related complications were 191.61 events per 1000 person-years (difference, 117.3; 95% CI, 112.8-121.8) for those exposed to both an anticoagulant and antiplatelet agent (IRR, 10.48; 95% CI, 8.16-13.45), 140.92 (difference, 57.7; 95% CI, 56.9-58.4) for those exposed to anticoagulants (IRR, 1.55; 95% CI, 1.52-1.59), and 110.72 (difference, 26.5; 95% CI, 25.9-27.0) for those exposed to antiplatelet agents (IRR, 1.31; 95% CI, 1.29-1.33). Patients exposed to antithrombotic agents, compared with patients not exposed to these drugs, were more likely to be diagnosed as having bladder cancer within 6 months (0.70% vs 0.38%; odds ratio, 1.85; 95% CI, 1.79-1.92).
结论
2518064名病人中,808897名病人(平均年龄72.16.8】岁,42853153%】名病人为女性)在受试阶段至少接受了一次抗血栓药物治疗。在7.3年的随访中期,在经常服用抗血栓药物的受试者中每年1000人中有123.5人患有血尿相关并发症,没有服用抗血栓药的受试者中每年1000人中有80.17人患有血尿相关并发症(差数,43.8; 95% CI, 43.0-44.6; P < .001, 发病率比 [IRR], 1.44; 95% CI, 1.42-1.46))。服用药物的受试者发生并发症的比例与未服用药物的人(80.17/1000)相比有105.78例需泌尿手术(差数, 33.5; 95% CI, 32.8-34.3; P < .001, and IRR, 1.37; 95% CI, 1.36-1.39),11.12例需住院治疗(差数, 5.7; 95% CI, 5.5-5.9; P < .001, and IRR, 2.03; 95% CI, 2.00-2.06), 7.05需急诊治疗(差数, 4.5; 95% CI, 4.3-4.7; P < .001, and IRR, 2.80; 95% CI, 2.74-2.86)。与未服用血栓药的人相比,服用抗血凝和抗血小板药物的受试者(IRR, 10.48; 95% CI, 8.16-13.45)血尿相关并发症比为191.61/1000(差数, 117.3; 95% CI, 112.8-121.8),服用抗血凝药物的受试者(IRR, 1.55; 95% CI, 1.52-1.59)为140.92(差数, 57.7; 95% CI, 56.9-58.4),服用抗血小板的受试者(IRR, 1.31; 95% CI, 1.29-1.33)为110.72(差数, 26.5; 95% CI, 25.9-27.0)。与未服用药物的病人相比,服用抗血栓药物的病人宰守师的6个月内更易患有膀胱癌(0.70% vs 0.38%; 让步比, 1.85; 95% CI, 1.79-1.92).

Conclusions and Relevance  
Among older adults in Ontario, Canada, use of antithrombotic medications, compared with nonuse of these medications, was significantly associated with higher rates of hematuria-related complications (including emergency department visits, hospitalizations, and urologic procedures to manage gross hematuria).
总结和相关结论
加拿大安大略省中进行抗血栓形成治疗的年纪较大的成年人与那些没有接受治疗的的人相比罹患血尿相关并发症的风险较大。(包括急症治疗,住院治疗,以及控制总血尿的相关泌尿过程)

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