【摘要】 目的评价口服糖皮质激素与心脑血管疾病事件发生风险的关系。方法收集2000 -2004年在我院住院的50岁以上患者资料,并随访至2005年,病例组2 035例为确诊的首次冠心病、心力衰竭、缺血性中风或短暂性脑缺血发作患者,对照组为无前述疾病患者。分析比较口服糖皮质激素与心脑血管事件的风险率(OR)。结果口服糖皮质激素与心脑血管事件明显相关(调整OR 1．20,95％CI为1．15-1．25),这种关系在现在应用糖皮质激素者较以往应用者更加明显,且与剂量正相关(调整OR 1．45,95％CI为1.32-1．55)。分层分析发现现在应用糖皮质激素与心力衰竭危险增加相关(调整OR 1．58,95％CI为1．41-1．78),且这种关系在合并风湿性关节炎(RA)、慢性阻塞性肺病(COPD)患者中是一致的,分别为(OR 1．45,95％CI为1．09-1．82)、(OR 2．85,95%CI为2．36-3．32)。而且,现在应用糖皮质激素与冠心病危险增加相关(调整OR 1．23,95%CI为1．06- 1．38)。结论口服糖皮质激素是心力衰竭的危险因素,尤其是现在大剂量服用者。提示临床应注意口服糖皮质激素对心血管疾病的影响,合并其它疾病时更为重要。更多还原

【Abstract】 Objective To assess oral glucocorticoids with the risk of cardiovascular and cerebro-vascular disease. Methods To collect the data came from our hospital in- patient(≥50years old) between 2000 and 2004 and follow up to the end of 2005, 2035 cases were defined as patients with a first record of ischaemic heart disease, heart failure, ischaemic stroke or transient ischaemic attack, and controls were no record of those disease. To compare and analysis odds ratio (OR) of cardiovascular and cerebrovascular envents in patients use of oral glucocorcoids to non-users. Results There was a significant association between ever use of oral glucocorticoids and any cardiovascular and cerebrovascular envents (adjusted OR1.20, 95%CI 1.15-1. 25). The association was stronger for current use of oral glucocorcoids than for recent or past use. Among current users, the highest ORs were observed in the group with the highest average daily dose (adjusted OR 1. 45, 95% CI1. 32-1. 55). To stratified analysis found current use was associated with an increased risk of heart failure (adjusted OR 1. 58, 95% CI1.41-1. 78), which was consistent between patients with rheumatoid arthritis(RA), patients with chronic obstructive pulmonary disease (COPD), and patients without either of the two condition (OR 1. 45, 95% CI 1.09-1. 82), (OR 2. 85, 95% CI 2. 36-3. 32). Also, current use was associated with a smaller increased risk of ischaemic heart disease (adjusted OR1. 23, 95% CI 1.06-1. 38). Conclusion Use of oral glucocorticoids was identified as a risk factor for heart failure, especially current higher users, especially patients have the complication as RA or COPD.更多还原