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重症患者血栓预防中的性别差异:随机试验的二次分析
Karen E A Burns1,2,3, Diane Heels-Ansdell3, Lehana Thabane3,4
1Interdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Toronto, ON, Canada.
概括
性关系影响了在重症患者中预防血栓的有效性. 与女性相比,达尔特帕林在预防静脉血栓塞栓症 (VTE) 方面对男性的益处更大,需要进一步调查.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 血栓形成的研究研究
背景情况:
- 静脉血栓栓塞 (VTE) 是重症患者经常出现的并发症.
- 在VTE风险和治疗反应方面,基于性别和性别的差异尚未得到充分理解.
- 关于性别如何影响血栓预防疗效的研究有限.
研究的目的:
- 为了研究性别对重症患者血栓预防治疗结果的影响.
- 为了评估达尔特帕林或未分离肝素 (UFH) 的疗效是否在男性和女性之间有所不同.
- 在PROTECT试验中分析性对血栓事件和死亡率的影响.
主要方法:
- 在重症监护试验 (PROTECT) 中对血栓栓塞的预防的二次分析.
- 考克斯比例危险分析,按中心和入院诊断分层.
- 在未调整和调整模型中包含性别,治疗和交互术语.
主要成果:
- 在深静脉血栓形成 (DVT),肺栓塞 (PE) 或死亡率方面没有显著的基于性别的差异.
- 对于任何VTE,观察到性别的统计学上显著的效果修饰,在男性中偏爱达尔特帕林 (HR 0.71) 与女性 (HR 1.16).
- 这一发现在调整基线特征和体重后仍然存在.
结论:
- 性别改变了在危急病患者中对静脉动脉瘤的血栓预防疗法的有效性.
- 观察到有利于男性使用达尔特帕林的效果需要在未来的研究中得到确认.
- 强调在重症监护研究中基于性别和性别分析的重要性.
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