乙醇胺可预防COPD和健康成年人的高度不良影响
Michael Furian1,2, Maamed Mademilov2,3, Aline Buergin1,2
1Department of Respiratory Medicine, University Hospital of Zurich, Zurich, Switzerland.
NEJM evidence
|January 31, 2024
概括
乙胺在健康人群中有效预防高空疾病,并在高空逗留期间减少慢性阻塞性肺病 (COPD) 患者的不良影响. 这种药物为旅行者和呼吸系统疾病患者提供了显著的好处.
科学领域:
- 高度医学 高度医学
- 肺部医学 肺部医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 高海拔旅行对健康人群和慢性阻塞性肺病 (COPD) 患者构成风险.
- 与高度相关的不良健康影响 (ARAHE) 和急性山病 (AMS) 是常见的担忧.
- 预防策略对于减轻这些风险至关重要.
研究的目的:
- 评估乙醇胺在预防COPD患者ARAHE的疗效.
- 评估阿西塔佐胺在预防40岁及以上健康低地人的AMS中的有效性.
- 确定阿西塔佐胺在高海拔适应过程中的安全性和治疗益处.
主要方法:
- 进行了两项随机,双盲,并行设计的试验.
- 试验1:176名COPD患者在3100米的2天停留之前接受了乙醇胺 (375毫克/天) 或安慰剂.
- 试验2:345名健康的低地人 (≥40岁) 遵循相同的方案,通过路易斯湖问卷评估AMS.
主要成果:
- 在COPD患者中,乙醇胺将ARAHE发病率从76% (安慰剂) 降低到49% (HR,0.54;P<0.001),NNT为4.
- 在健康的低地人中,乙醇胺使AMS发病率从32% (安慰剂) 降低到22% (HR,0.48;P=0.035),NNT为10.
- 在这两项试验中都没有报告任何严重不良事件.
结论:
- 乙胺显著降低了需要干预的高空不良影响在COPD患者的发生率.
- 预防性阿扎胺治疗有效降低高海拔地区健康的老年低地人中AMS的发生率.
- 在这两种患者群体中,乙醇胺是一种安全有效的预防剂,用于高海拔逗留.
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