类他类药物治疗对呼吸器相关肺炎患者死亡率的影响:一项随机临床试验
Laurent Papazian1, Antoine Roch, Pierre-Emmanuel Charles
1Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Réanimation des Détresses Respiratoires et des Infections Sévères UMR-CNRS 7278, Aix-Marseile Université, Marseille, France.
JAMA
|October 11, 2013
概括
西姆瓦斯塔丁并没有改善呼吸器相关性肺炎 (VAP) 患者的生存率. 这项随机试验没有发现28日死亡率有显著的降低,这表明他类药物对VAP结果没有好处.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 观察性研究表明,使用他类药物可以改善各种感染的结果.
- 呼吸机相关肺炎 (VAP) 是一种常见的,往往致命的重症监护室 (ICU) 感染.
研究的目的:
- 为了调查静止素治疗 (simvastatin) 是否降低了被诊断为VAP的患者的28天死亡率.
主要方法:
- 一个多中心,随机,安慰剂控制,双盲试验,涉及300名疑似VAP需要机械通风的患者.
- 患者每天接受simvastatin (60mg) 或安慰剂,直到ICU出院,死亡或28日.
- 主要结局是28日死亡率;次要结局包括其他死亡率和机械通风的持续时间.
主要成果:
- 审判因为徒劳而提前停止. 28日死亡率为西姆瓦斯塔丁的21.2%,与安慰剂的15.2%相比 (P=.10).
- 在未服用他类药物的患者中,simvastatin治疗28日死亡率为21.5%,而安慰剂治疗13.8% (P=.054).
- 在第14天,ICU或医院死亡率或机械通风持续时间方面没有发现显著差异.
结论:
- 在怀疑VAP的成年人中,辅助的simvastatin治疗没有改善28天的存活率.
- 这些发现不支持使用他类药物来改善VAP结果.
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