在结核性约束性心周炎的手术前含有皮拉津胺的治疗的临床意义
Likui Fang1, Wenfeng Yu1, Guocan Yu1
1Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, 310003, People's Republic of China.
Infection and drug resistance
|January 17, 2024
概括
在心膜切除术前使用pyrazinamide进行手术前的抗结核疗法与活跃结核收缩性心膜炎 (TCP) 的风险较低有关. 这一策略可以改善手术结果,并降低TCP患者的成本.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 胸部外科手术 胸部外科手术
背景情况:
- 结核性收缩性心膜炎 (TCP) 的管理包括在心膜切除术之前进行抗结核 (TB) 治疗.
- 不同的手术前抗结核病治疗方案对手术结果的影响仍然不清楚.
研究的目的:
- 调查手术前抗结核病疗法与接受TCP心脏切除术的患者的结局之间的关联.
- 识别影响活跃TCP (A-TCP) 的因素,并比较活跃和不活跃的TCP组之间的外科手术结果.
主要方法:
- 追溯收集了102名被诊断患有TCP的患者,这些患者接受了心膜切除术.
- 根据Mycobacterium tuberculosis (MTB) 培养和RNA测定,患者被分为活跃的TCP (A-TCP) 和不活跃的TCP (IA-TCP) 组.
- 基线特征,抗结核病方案和手术结果的比较;进行了后勤回归和子组分析.
主要成果:
- 与IA-TCP组 (74.4%) 相比,在A-TCP组 (37.5%) 中使用含有Pyrazinamide的抗结核病疗法的频率较低.
- 手术前使用皮拉津胺是对A-TCP的保护因素 (OR 0.194,P = 0.013).
- A-TCP是术后心脏并发症 (OR 4.231,P = 0.015),更长时间住院和更高成本的独立风险因素.
结论:
- 在心心切除术前使用包括pyrazinamide在内的抗结核疗法对TCP患者来说是优越的.
- 这一策略与降低A-TCP风险,潜在的更好的术后恢复和更好的成本效益有关.
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