Phenylpropanolamine and the risk of hemorrhagic stroke.
Phenylpropanolamine and the risk of hemorrhagic stroke.
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DOI：
10.1056/nejm200012213432501
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发表时间：
2000-12-21
影响因子：
158.5
通讯作者：
Horwitz, RI
中科院分区：
文献类型：
--
作者：
Kernan, WN;Viscoli, CM;Horwitz, RI
背景：苯丙醇胺通常存在于食欲抑制药和咳嗽或感冒药中。病例报告将含有苯丙醇胺的产品的使用与出血性中风联系在一起，通常是在首次使用这些产品之后。为了研究这种相关性，我们设计了一项病例对照研究。方法：从美国43家医院招募了年龄在18岁到49岁之间的男性和女性。资格标准包括在登记前30天内发生蛛网膜下腔出血或脑内出血，以及没有先前诊断的脑损伤。结果：共有702例患者和1376例对照受试者。对于女性，调整后的优势比为16.58(95%可信区间，1.5 1至182.21；P=0.02)，与使用含有苯丙醇胺的食欲抑制药和出血性中风的风险有关；3.13(95%可信区间，0.86至11.46；P=0.08)与首次使用含有苯丙醇胺的产品有关。所有苯丙醇胺的首次使用都涉及咳嗽或感冒药。男性和女性合并后，使用含有苯丙醇胺的产品与出血性中风风险之间的调整优势比为1.49(95%可信区间，0.84至2.64；P=0.17)，与使用含有苯丙醇胺的咳嗽或感冒药有关的调整后的优势比为1.23(95%可信区间，0.68至2.24；P=0.49)，与使用含有苯丙醇胺的食欲抑制药有关的调整后的优势比为15.92(95%可信区间，1.38至184.13；P=0.03)。一项对男性的分析表明，使用含有苯丙醇胺的咳嗽或感冒药并不会增加出血性中风的风险。结论：结果表明，苯丙醇胺在食欲抑制剂中，可能在咳嗽和感冒药中，是女性出血性中风的独立危险因素。(N Engl J Med 2000；343：1826-32)(C)2000年，马萨诸塞州医学会。
Background: Phenylpropanolamine is commonly found in appetite suppressants and cough or cold remedies. Case reports have linked the use of products containing phenylpropanolamine to hemorrhagic stroke, often after the first use of these products. To study the association, we designed a case-control study.Methods: Men and women 18 to 49 years of age were recruited from 43 U.S. hospitals. Eligibility criteria included the occurrence of a subarachnoid or intracerebral hemorrhage within 30 days before enrollment and the absence of a previously diagnosed brain lesion. Random-digit dialing identified two matched control subjects per patient.Results: There were 702 patients and 1376 control subjects. For women, the adjusted odds ratio was 16.58 (95 percent confidence interval, 1.51 to 182.21; P=0.02) for the association between the use of appetite suppressants containing phenylpropanolamine and the risk of a hemorrhagic stroke and 3.13 (95 percent confidence interval, 0.86 to 11.46; P=0.08) for the association with the first use of a product containing phenylpropanolamine. All first uses of phenylpropanolamine involved cough or cold remedies. For men and women combined, the adjusted odds ratio was 1.49 (95 percent confidence interval, 0.84 to 2.64; P=0.17) for the association between the use of a product containing phenylpropanolamine and the risk of a hemorrhagic stroke, 1.23 (95 percent confidence interval, 0.68 to 2.24; P=0.49) for the association with the use of cough or cold remedies that contained phenylpropanolamine, and 15.92 (95 percent confidence interval, 1.38 to 184.13; P=0.03) for the association with the use of appetite suppressants that contained phenylpropanolamine. An analysis in men showed no increased risk of a hemorrhagic stroke in association with the use of cough or cold remedies containing phenylpropanolamine. No men reported the use of appetite suppressants.Conclusions: The results suggest that phenylpropanolamine in appetite suppressants, and possibly in cough and cold remedies, is an independent risk factor for hemorrhagic stroke in women. (N Engl J Med 2000;343:1826-32.) (C) 2000, Massachusetts Medical Society.