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ИПП и преждевременная смерть | Изжоги.нет - информационный портал | Новости

Учёные: ИПП повышают риск преждевременной смерти


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Ингибиторы протонной помпы (ИПП), которые во всём мире широко применяются при лечении различных патологий желудочно-кишечного тракта, связывают с повышенным риском преждевременной смерти. По крайней мере, такой вывод сделали учёные из Школы медицины Университета Вашингтона (США).

Доктор Зияд Аль-Али и его коллеги изучили истории болезни примерно 275 тысяч человек, использующих ИПП, и ещё 75 тысяч пациентов, принимающих для снижения уровня соляной кислоты в желудке H2-блокаторы гистаминовых рецепторов.

И ИПП, и Н2-блокаторы назначают при серьезных заболеваниях, таких как кровотечение в верхних отделах желудочно-кишечного тракта, гастроэзофагеальная рефлюксная болезнь (ГЭРБ), пищевод Барретта и рак пищевода. Безрецептурные ингибиторы протонной помпы чаще всего используются для лечения изжоги и расстройств желудка. Такие ИПП содержат те же самые химические соединения, что и ИПП по рецепту, но в более низких дозах.

Будучи врачом-нефрологом, Аль-Али ранее уже проследил взаимосвязь между ИПП и почечными болезнями. Параллельно другие учёные установили, что приём этих препаратов сказывается на развитии деменции, пневмонии, остеопороза и сердечно-сосудистых патологий. Тогда доктор Зияд Аль-Али сделал закономерное предположение: каждый из этих побочных эффектов несет небольшой риск смерти, а все вместе они могут повлиять на коэффициент смертности среди больных, принимающих ИПП.

Гипотеза подтвердилась, когда исследователи «перелопатили» данные медкарт сотен тысяч пациентов. У людей, которым назначали ИПП, на 25% был повышен риск преждевременной смерти. Учёные подсчитали, что на каждые 500 человек, получающих ингибиторы в течение года, есть одна смерть, которой могло и не быть. Учитывая, что ежегодно миллионы людей принимают эти лекарства – часто без острой необходимости – таких преждевременных смертей во всём мире тысячи.

Специалисты отмечают закономерность: чем дольше пациент принимает ИПП, тем выше риск преждевременной смерти. 30-дневный курс существенно не влияет на состояние здоровья, а вот приём препаратов в течение одного-двух лет повышает шансы внезапно умереть без видимых причин до 50%.

Несмотря на то, что рекомендуемый курс лечения ИПП в среднем составляет две-восемь недель, многие люди продолжают принимать эти препараты в течение нескольких месяцев или даже лет. Медики не призывают полностью отказаться от использования ингибиторов протонной помпы, но предлагают делать это более осознанно – применять при тяжёлой болезни, только по указанию лечащего врача и в строго определенные сроки.


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    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '40'
    
    Debug: (0,075789) - (usage: 4331536) - (peak: 4504616)
    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '41'
    
    Debug: (0,07593) - (usage: 4335784) - (peak: 4509008)
    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '42'
    
    Debug: (0,07607) - (usage: 4340056) - (peak: 4513360)
    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '43'
    
    Debug: (0,076209) - (usage: 4344336) - (peak: 4517800)
    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '44'
    
    Debug: (0,076433) - (usage: 4348616) - (peak: 4522224)
    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '45'
    
    Debug: (0,076599) - (usage: 4352888) - (peak: 4526616)
    (mysql): SELECT * FROM izjoga_content_props WHERE content_id = '46'
    
    Debug: (0,076791) - (usage: 4359928) - (peak: 4530888)
    (mysql): SELECT * FROM izjoga_content WHERE content_id IN (23) ORDER BY hierarchy
    
    Debug: (0,077208) - (usage: 4405464) - (peak: 4566056)
    (mysql): SELECT * from izjoga_module_templates WHERE module_name = 'MenuManager' and template_name = 'new' LIMIT  1
    
    Debug: (0,077354) - (usage: 4410400) - (peak: 4582456)
    (mysql): SELECT module_name,template_name,modified_date 
                                FROM izjoga_module_templates
    
    Debug display of 'End of Menu Manager Display':(0,093402) - (usage: 4445856) - (peak: 4812368)
    Debug: (0,093468) - (usage: 4419168) - (peak: 4812368)
    start global_content_get_template
    Debug: (0,093682) - (usage: 4443272) - (peak: 4812368)
    Loading /var/www/vhosts/izjogi.net/httpdocs/lib/classes/class.globalcontentoperations.inc.php = 22784 bytes for an approximate total of 1096776
    Debug: (0,093888) - (usage: 4449248) - (peak: 4812368)
    (mysql): SELECT htmlblob_id, htmlblob_name, html, owner, use_wysiwyg, description, modified_date FROM izjoga_htmlblobs WHERE htmlblob_name = 'Search' LIMIT  1
    
    Debug: (0,093972) - (usage: 4451248) - (peak: 4812368)
    end global_content_get_template
    Debug: (0,093993) - (usage: 4451592) - (peak: 4812368)
    start global_content_get_timestamp
    Debug: (0,094011) - (usage: 4452008) - (peak: 4812368)
    end global_content_get_timestamp
    Debug: (0,095444) - (usage: 4479024) - (peak: 4825016)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGExtensions/lib/class.cge_tmpdata.php = 3440 bytes for an approximate total of 1100216
    Debug: (0,09608) - (usage: 4518384) - (peak: 4825016)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGExtensions/lib/class.cge_utils.php = 8184 bytes for an approximate total of 1108400
    Debug: (0,096114) - (usage: 4517272) - (peak: 4825016)
    Nothing is known about FrontEndUsers... cant load it
    Debug: (0,097086) - (usage: 4625888) - (peak: 4825016)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGBlog/lib/class.cgblog_article.php = 106632 bytes for an approximate total of 1215032
    Debug: (0,097324) - (usage: 4631080) - (peak: 4825024)
    (mysql): SELECT mn.* FROM izjoga_module_cgblog mn WHERE status = 'published' AND  cgblog_id = 117 LIMIT  1
    
    Debug: (0,097573) - (usage: 4643416) - (peak: 4830464)
    (mysql): SELECT A.value,B.id,B.name,B.type 
                  FROM izjoga_module_cgblog_fieldvals A, izjoga_module_cgblog_fielddefs B 
                  WHERE A.fielddef_id = B.id AND A.cgblog_id = '117' ORDER BY B.item_order
    
    Debug: (0,098103) - (usage: 4664088) - (peak: 4841224)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGBlog/lib/class.cgblog_field.php = 19296 bytes for an approximate total of 1234328
    Debug: (0,09833) - (usage: 4667240) - (peak: 4853088)
    (mysql): SELECT A.category_id,B.name 
                      FROM izjoga_module_cgblog_blog_categories A
                      LEFT JOIN izjoga_module_cgblog_categories B
                        ON A.category_id = B.id
                     WHERE A.blog_id = '117'
    
    Debug: (0,098483) - (usage: 4662048) - (peak: 4855536)
    (mysql): UPDATE izjoga_module_cgblog SET views = views + 1 WHERE cgblog_id = 117
    
    Debug: (0,098751) - (usage: 4688392) - (peak: 4874616)
    (mysql): SELECT * from izjoga_module_templates WHERE module_name = 'CGBlog' and template_name = 'detailSample' LIMIT  1
    
    Debug: (0,109126) - (usage: 4851392) - (peak: 5189568)
    Nothing is known about FrontEndUsers... cant load it
    Debug: (0,109781) - (usage: 4858312) - (peak: 5189568)
    (mysql): SELECT count(DISTINCT mn.cgblog_id) as count
                 FROM izjoga_module_cgblog mn WHERE status = 'published' AND ( IFNULL(start_time, '1970-01-01 03:00:01')  < '2018-12-18 17:57:44') AND (( IFNULL(end_time, '1970-01-01 03:00:01')  = '1970-01-01 03:00:01') OR (end_time > '2018-12-18 17:57:44')) LIMIT  1
    
    Debug: (0,111932) - (usage: 4866456) - (peak: 5189568)
    (mysql): SELECT DISTINCT mn.*
                 FROM izjoga_module_cgblog mn WHERE status = 'published' AND ( IFNULL(start_time, '1970-01-01 03:00:01')  < '2018-12-18 17:57:44') AND (( IFNULL(end_time, '1970-01-01 03:00:01')  = '1970-01-01 03:00:01') OR (end_time > '2018-12-18 17:57:44'))  ORDER BY RAND() desc LIMIT 0, 2
    
    Debug: (0,112101) - (usage: 4877624) - (peak: 5189568)
    (mysql): SELECT A.category_id,B.name 
                      FROM izjoga_module_cgblog_blog_categories A
                      LEFT JOIN izjoga_module_cgblog_categories B
                        ON A.category_id = B.id
                     WHERE A.blog_id = '109'
    
    Debug: (0,112237) - (usage: 4879600) - (peak: 5189568)
    (mysql): SELECT A.value,B.id,B.name,B.type FROM izjoga_module_cgblog_fieldvals A, izjoga_module_cgblog_fielddefs B WHERE A.fielddef_id = B.id AND B.public = 1 AND A.cgblog_id = '109' ORDER BY B.item_order
    
    Debug: (0,112964) - (usage: 4887936) - (peak: 5225592)
    (mysql): SELECT A.category_id,B.name 
                      FROM izjoga_module_cgblog_blog_categories A
                      LEFT JOIN izjoga_module_cgblog_categories B
                        ON A.category_id = B.id
                     WHERE A.blog_id = '40'
    
    Debug: (0,113105) - (usage: 4889568) - (peak: 5225592)
    (mysql): SELECT A.value,B.id,B.name,B.type FROM izjoga_module_cgblog_fieldvals A, izjoga_module_cgblog_fielddefs B WHERE A.fielddef_id = B.id AND B.public = 1 AND A.cgblog_id = '40' ORDER BY B.item_order
    
    Debug: (0,113772) - (usage: 4913784) - (peak: 5229296)
    (mysql): SELECT * from izjoga_module_templates WHERE module_name = 'CGBlog' and template_name = 'summarysameArticles' LIMIT  1
    
    Debug: (0,118617) - (usage: 4897160) - (peak: 5337752)
    Nothing is known about FrontEndUsers... cant load it
    Debug: (0,11904) - (usage: 4901304) - (peak: 5337752)
    (mysql): SELECT id FROM izjoga_module_cgblog_categories WHERE name IN ('news')
    
    Debug: (0,119432) - (usage: 4911848) - (peak: 5337752)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGExtensions/lib/class.cge_array.php = 8584 bytes for an approximate total of 1242912
    Debug: (0,11978) - (usage: 4916336) - (peak: 5337752)
    (mysql): SELECT count(DISTINCT mn.cgblog_id) as count
                 FROM izjoga_module_cgblog mn LEFT OUTER JOIN izjoga_module_cgblog_blog_categories bc ON mn.cgblog_id = bc.blog_id WHERE status = 'published' AND ( IFNULL(start_time, '1970-01-01 03:00:01')  < '2018-12-18 17:57:44') AND bc.category_id IN (4) AND (( IFNULL(end_time, '1970-01-01 03:00:01')  = '1970-01-01 03:00:01') OR (end_time > '2018-12-18 17:57:44')) LIMIT  1
    
    Debug: (0,121329) - (usage: 4921632) - (peak: 5337752)
    (mysql): SELECT DISTINCT mn.*
                 FROM izjoga_module_cgblog mn LEFT OUTER JOIN izjoga_module_cgblog_blog_categories bc ON mn.cgblog_id = bc.blog_id WHERE status = 'published' AND ( IFNULL(start_time, '1970-01-01 03:00:01')  < '2018-12-18 17:57:44') AND bc.category_id IN (4) AND (( IFNULL(end_time, '1970-01-01 03:00:01')  = '1970-01-01 03:00:01') OR (end_time > '2018-12-18 17:57:44')) ORDER BY mn.cgblog_date desc LIMIT 0, 1
    
    Debug: (0,121485) - (usage: 4929672) - (peak: 5337752)
    (mysql): SELECT A.category_id,B.name 
                      FROM izjoga_module_cgblog_blog_categories A
                      LEFT JOIN izjoga_module_cgblog_categories B
                        ON A.category_id = B.id
                     WHERE A.blog_id = '166'
    
    Debug: (0,12175) - (usage: 4931024) - (peak: 5337752)
    (mysql): SELECT A.value,B.id,B.name,B.type FROM izjoga_module_cgblog_fieldvals A, izjoga_module_cgblog_fielddefs B WHERE A.fielddef_id = B.id AND B.public = 1 AND A.cgblog_id = '166' ORDER BY B.item_order
    
    Debug: (0,122623) - (usage: 4950040) - (peak: 5337752)
    (mysql): SELECT * from izjoga_module_templates WHERE module_name = 'CGBlog' and template_name = 'summaryrightNews' LIMIT  1
    
    Debug: (0,123497) - (usage: 5060160) - (peak: 5343808)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGExtensions/lib/class.cge_smarty_plugins.php = 15856 bytes for an approximate total of 1258768
    Debug: (0,125827) - (usage: 4924400) - (peak: 5357824)
    (mysql): SELECT count(mq.id) as num
                FROM izjoga_module_questions_questions mq
                LEFT OUTER JOIN izjoga_module_questions_categories mqc
                  ON mqc.id = mq.category_id WHERE mq.answered_date IS NOT NULL AND mq.approved_date IS NOT NULL LIMIT  1
    
    Debug: (0,126586) - (usage: 4931584) - (peak: 5357824)
    (mysql): SELECT mq.*, mqc.name, mqc.long_name
                FROM izjoga_module_questions_questions mq
                LEFT OUTER JOIN izjoga_module_questions_categories mqc
                  ON mqc.id = mq.category_id WHERE mq.answered_date IS NOT NULL AND mq.approved_date IS NOT NULL ORDER BY 8 ASC LIMIT 0,1
    
    Debug: (0,127084) - (usage: 4963720) - (peak: 5357824)
    (mysql): SELECT * from izjoga_module_templates WHERE module_name = 'Questions' and template_name = 'summaryqaRight' LIMIT  1
    
    Debug: (0,135766) - (usage: 4811760) - (peak: 5357824)
    calling module CGExtensions from event ContentPostRender
    Debug: (0,136105) - (usage: 4820720) - (peak: 5357824)
    Loading /var/www/vhosts/izjogi.net/httpdocs/modules/CGExtensions/lib/class.cge_headers.php = 2872 bytes for an approximate total of 1261640
    Debug: (0,136125) - (usage: 4815880) - (peak: 5357824)
    calling module TinyMCE from event ContentPostRender