目前用于肝综合征-急性损伤的药理疗法
Nikki Duong1, Payal Kakadiya2, Jasmohan S Bajaj1
1Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University and Central Virginia Veterans Healthcare System, Richmond, Virginia.
概括
肝炎综合征 (HRS) 药物治疗已经进化,特里普林素和白蛋白显示出改善的逆转率. 需要进行进一步的研究,以优化HRS-AKI患者的血管收缩剂使用.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 肝硬化症候群 (HRS) 在肝硬化和中是由于管血管扩张和脏低的结果.
- HRS是一种排除诊断,死亡率高 (在没有治疗的2周内超过80%).
研究的目的:
- 审查用于肝综合征药物治疗的随机对照试验 (RCT).
- 突出HRS治疗策略的最新进展.
主要方法:
- 在过去25年中发表的RCT的综合PubMed审查.
- 将18项相关研究纳入分析.
主要成果:
- 上腺素和terlipressin在HRS逆转方面表现出类似的疗效.
- 与专相结合的特里普林素显著改善了与单独专相比,HRS逆转率.
- 米多德林,八丁和白蛋白显示中度有效性,在30天死亡率方面表现优于单独的白蛋白.
结论:
- 最近的RCT提高了对HRS治疗的理解,特别是HRS-AKI.
- 特里普林是FDA批准的,但具有成本效益的替代品和最佳使用方案需要进一步调查.
- 未来的多中心研究对于完善HRS-AKI中血管收缩剂的风险益益比至关重要.
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