Use of Selective Serotonin Reuptake Inhibitors and Risks of Stroke in Patients with Obsessive Compulsive Disorder: A Population-Based Study.
Use of Selective Serotonin Reuptake Inhibitors and Risks of Stroke in Patients with Obsessive Compulsive Disorder: A Population-Based Study.
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在强迫症患者中使用选择性5-羟色胺再摄取抑制剂和中风风险：一项基于人群的研究。
DOI：
10.1371/journal.pone.0162239
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Nestadt G
中科院分区：
文献类型：
--
作者：
Chu CS;Chou PH;Lin CH;Cheng C;Tsai CJ;Lan TH;Huang MW;Nestadt G
以前的研究表明抗抑郁药的使用与脑血管事件的发生之间存在联系，但从未有任何研究调查过接受选择性5-羟色胺再摄取抑制剂（SSRI）治疗的强迫症（OCD）患者的中风风险。本研究以2001年至2009年台湾全民健康保险资料库的资料，进行回顾性观察性群组研究。共纳入527名强迫症患者，其中SSRI使用组412名，非SSRI使用组115名。多变量考克斯比例风险模型被用来探索SSRI使用和卒中发生之间的关系，控制年龄、性别、伴随用药和共病医学疾病。在随访期间，共有19名强迫症患者被诊断为新发卒中，其中SSRI组6例，非SSRI组13例。SSRI的使用被证明与卒中风险降低相关（风险比[HR] = 0.30; 95%置信区间[CI] = 0.10-0.86，P = 0.02）。与年龄相关的脑卒中风险每10年增加2.55例（HR = 2.55; 95% CI = 1.74-3.75，P<0.001）。另外，性别、阿司匹林和非甾体抗炎药的合并使用、心绞痛、糖尿病、高血压和高脂血症的合并症与强迫症患者卒中风险增加无关。我们的研究表明，SSRI的使用与降低强迫症患者中风的风险有关。对强迫症患者使用SSRI与卒中之间关系的潜在生物学机制进行进一步研究是必要的。
Previous research has suggested a link between antidepressants use and the development of cerebrovascular events, but there has never been any study investigating the risk of stroke in obsessive-compulsive disorder (OCD) patients treated with a selective serotonin reuptake inhibitor (SSRI). A retrospective observational cohort study was conducted using data from the National Health Insurance Database of Taiwan between the year of 2001 and 2009. A total of 527 OCD patients with 412 subjects in the SSRI use group and 115 in the non SSRI use group were included. Multivariable Cox proportional-hazards models were used to explore the associations between SSRI use and the occurrence of stroke, controlling for age, gender, concomitant medications, and comorbid medical illnesses. A total of nineteen OCD patients were diagnosed with new onset of stroke during the follow-up period including six cases in the SSRI group and thirteen in the non SSRI use group. SSRI use was demonstrated to be associated with a decreased risk of stroke (hazard ratio [HR] = 0.30; 95% confidence interval [CI] = 0.10–0.86, P = 0.02). The increase in age-related risk of strokes was 2.55 per decade (HR = 2.55; 95% CI = 1.74–3.75, P<0.001). Alternatively, sex, concomitant use of aspirin and non-steroidal anti-inflammatory drugs, and comorbidities with angina pectoris, diabetes mellitus, hypertension, and hyperlipidemia were not found to be associated with an increased risk for stroke in OCD patients. Our study showed that SSRI use was associated with decreased risk of stroke in OCD patients. Further investigation into the possible biological mechanisms underlying the relationship between stroke and SSRI use in OCD patients is warranted.
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影响因子：
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