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紧密的心率控制可以减少B型急性大动脉切割患者的次要不良事件
Kazuhisa Kodama1, Kazuhiro Nishigami, Tomohiro Sakamoto
1Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami, Kumamoto 861-4193, Japan.
Circulation
|October 10, 2008
概括
紧密的心率控制显著减少了B型大动脉剖析患者的大动脉事件. 与传统的心率控制相比,这种医疗管理策略可以改善结果.
科学领域:
- 心血管医学 心血管医学
- 血管外科 血管外科
- 临床试验 临床试验
背景情况:
- 传统上,B型大动脉剖析的管理重点是降低血压.
- 关于心率控制对这些患者的影响的证据有限.
- β抑制剂用于血压管理,但它们对心率的影响需要进一步调查.
研究的目的:
- 评估严格的心率控制是否改善了大动脉剖析的医疗治疗患者的结果.
- 为了比较紧张和传统心率控制组之间的大动脉事件发生率.
主要方法:
- 171名急性大动脉解剖患者接受了医疗治疗,他们的血压<120 mmHg.
- 患者被分为紧张的心率 (<60 bpm) 和常规心率 (>=60 bpm) 控制组.
- 将大动脉事件 (缺血,破裂,解剖,扩张) 和手术需求进行了比较.
主要成果:
- 紧张心率控制组 (32名患者) 的平均HR为每小时56.6次.
- 传统HR对照组 (139名患者) 的HR平均为每小时71.7 bpm.
- 大动脉事件发生在紧张HR组的12.5%,而常规组的36.0% (OR0.25,P<0.01).
结论:
- 紧张的心率控制与大动脉事件的显著减少有关.
- 这一策略提高了对患有大动脉解剖的患者的医疗治疗结果.
- 针对较低的心率可能是管理大动脉剖析的关键组成部分.
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