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首页> 外文期刊>Current opinion in gastroenterology >Adverse effects of proton pump inhibitor drugs: clues and conclusions.
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Adverse effects of proton pump inhibitor drugs: clues and conclusions.

机译：质子泵抑制剂药物的不良反应：线索和结论。

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摘要

PURPOSE OF REVIEW: To review evidence relating to the strength of associations that have appeared in largely observational studies, between high-dose or long-term use of proton pump inhibitor drugs and certain possibly attributable side-effects, which emerge from studies confounded by other variables. In retrospective studies not designed to assess safety, evidence of causality is generally lacking. RECENT FINDINGS: The associations of fractures of hip, wrist, forearm and other sites appear weak and only slightly higher than the risks in control populations matched for age. They may increase with drug exposure, but probably do so only in individuals in whom other risk factors are also operational (smoking, alcohol, poor nutrition, steroids, etc.). The risks of Clostridium difficile colitis, other enteric infections, small bowel bacterial overgrowth and possibly spontaneous bacterial peritonitis also appear increased. Impaired gastric secretion may adversely affect the absorption of various nutrients, but their clinical impact is ill defined. Potentially more important are the consequences of hypergastrinemia, including rebound hypersecretion of acid, and possible development of various cancers, including carcinoid tumors. Effects of other drugs, including clopidogrel, on metabolism are reviewed, but clouded by uncertainties. SUMMARY: The safety of long-term PPI administration needs serious prospective study.
机译：审查目的：审查与大量观察性研究中出现的关联强度有关的证据，这些关联在高剂量或长期使用质子泵抑制剂药物与某些可能归因于其他研究混淆的研究中产生的副作用之间变量。在并非旨在评估安全性的回顾性研究中，通常缺乏因果关系的证据。最近的发现：髋部，腕部，前臂和其他部位的骨折相关性较弱，仅略高于年龄相匹配的对照人群的风险。它们可能会随着药物暴露而增加，但可能仅在其他危险因素也起作用（吸烟，饮酒，营养不良，类固醇等）的个体中才会增加。艰难梭菌结肠炎，其他肠道感染，小肠细菌过度生长以及可能自发性细菌性腹膜炎的风险也增加了。胃分泌物受损可能会不利地影响各种营养素的吸收，但其临床影响尚不清楚。可能更重要的是高胃泌素血症的后果，包括酸的反弹性过度分泌，以及包括类癌在内的各种癌症的可能发展。综述了包括氯吡格雷在内的其他药物对代谢的影响，但由于不确定因素而模糊不清。摘要：长期PPI管理的安全性需要认真的前瞻性研究。

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