Appetite-suppressant drugs and the risk of primary pulmonary hypertension
Appetite-suppressant drugs and the risk of primary pulmonary hypertension
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DOI：
10.1056/nejm199608293350901
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发表时间：
1996-08-29
影响因子：
158.5
通讯作者：
Begaud, B
中科院分区：
文献类型：
--
作者：
Abenhaim, L;Moride, Y;Begaud, B
背景最近在法国，原发性肺动脉高压发生在一群暴露于用于控制体重的食欲抑制剂（食欲抑制剂）中芬氟拉明衍生物的患者中。我们调查了抗心律失常药物和其他可疑危险因素对原发性肺动脉高压的潜在作用。方法在一项病例对照研究中，我们评估了来自法国、比利时、英国、美国、加拿大、英国、美国、加拿大、加拿大和荷兰的355名对照组，与患者的性别和年龄相匹配。（主要是芬氟拉明的衍生物）与原发性肺动脉高压的风险增加有关（与使用任何抗氧化药物的比值比为6.3; 95%可信区间为3.0 ~ 13.2）。对于前一年使用抗抑郁药的患者，优势比为10.1（95%置信区间为3.4 - 29.9）。当使用抗抑郁药超过三个月时，优势比为23.1（95%置信区间为6.9至77.7）。我们还证实了与几个先前确定的危险因素：肺动脉高压家族史，感染人类免疫缺陷病毒，肝硬化，使用可卡因或静脉注射药物。结论使用抗抑郁药与原发性肺动脉高压的发展。应考虑对这一疾病进行积极监测，特别是因为预计在不久的将来，抗结核药物的使用将增加。(C)1996年，马萨诸塞州医学会。
Background Recently in France, primary pulmonary hypertension developed in a cluster of patients exposed to derivatives of fenfluramine in appetite suppressants (anorexic agents), which are used for weight control. We investigated the potential role of anorexic agents and other suspected risk factors for primary pulmonary hypertension.Methods In a case-control study, we assessed 95 patients with primary pulmonary hypertension from 35 centers in France, Belgium, the United Kingdom, and the Netherlands and 355 controls recruited from general practices and matched to the patients' sex and age.Results The use of anorexic drugs (mainly derivatives of fenfluramine) was associated with an increased risk of primary pulmonary hypertension (odds ratio with any anorexic-drug use, 6.3; 95 percent confidence interval, 3.0 to 13.2). For the use of anorexic agents in the preceding year, the odds ratio was 10.1 (95 percent confidence interval, 3.4 to 29.9). When anorexic drugs were used for a total of more than three months, the odds ratio was 23.1 (95 percent confidence interval, 6.9 to 77.7). We also confirmed an association with several previously identified risk factors: a family history of pulmonary hypertension, infection with the human immunodeficiency virus, cirrhosis, and use of cocaine or intravenous drugs.Conclusions The use of anorexic drugs was associated with the development of primary pulmonary hypertension. Active surveillance for this disease should be considered, particularly since the use of anorexic drugs is expected to increase in the near future. (C) 1996, Massachusetts Medical Society.