提氨酸在败血性休克中保护脏 (TRPSS):一个随机的,安慰剂控制的临床试验
Ari Moskowitz1,2,3, Katherine M Berg3,4, Anne V Grossestreuer3,5
1Division of Critical Care Medicine, Montefiore Medical Center, The Bronx, New York.
概括
胺补充剂没有显著减少败血症休克患者的损伤. 然而,那些接受胺的人经历了更多的无ICU日,这表明在康复方面有潜在的益处. 需要进一步的研究来探索这种效应.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學.
- 生物化学 生物化学
背景情况:
- 败血症引起的损伤是与患者不良结果相关的重大并发症.
- 线粒体功能障碍在败血性损伤中起着关键作用.
- 胺 (维生素B1) 已被提议作为潜在的治疗药物用于线粒体复苏在败血症.
研究的目的:
- 评估胺补充剂在减轻败血症休克患者中脏损伤的疗效.
- 评估胺对血清肌水平,脏替代疗法,急性脏损伤发生率和败血症休克死亡率的影响.
主要方法:
- 这项研究是性休克时脏保护胺 (TRPSS) 试验,这是一项多中心,随机,安慰剂控制的临床试验.
- 88名患有败血性休克的患者被随机分配,接受胺或安慰剂.
- 主要结局是从注册到72小时后血清肌素的变化.
主要成果:
- 在胺和安慰剂组之间在72小时内没有观察到血清肌素变化的显著差异 (P=0.07).
- 替代疗法 (14.3%对21.7%),急性损伤 (54.7%对73.9%) 和死亡率 (35.7%对54.3%) 的比率在各组之间没有显著差异.
- 接受胺治疗的患者在无密室治疗日数显著增加 (中位数为22.5与0.0,P<0.01).
结论:
- 胺补充剂在减少败血症休克患者损伤标志物方面没有显示出统计学上显著的益处.
- 虽然没有影响初级结结果,但胺的使用与无需ICU的日数增加有关.
- 这项以NCT03550794注册的研究提供了关于胺在感染性休克管理中的作用的见解.
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