红红素在败血症患者的免疫效应和临床影响:一项随机临床试验
Ahlem Trifi1, Badis Tlili1, Maryam Kallel Sellami2
1Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia.
Journal of critical care
|February 15, 2024
概括
在一项随机试验中,红素没有改善败血症生物标志物或减少死亡率. 这种抗生素添加到标准护理中对败血症患者没有益处,既没有影响炎症,也没有影响生存率.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 败血症是一种危及生命的器官功能障碍,是由宿主对感染的反应失调引起的.
- TNF/IL-10比率是一个关键的生物标志物,反映了败血症中促炎和抗炎的平衡.
- 红素在调节败血症生物标志物和临床结果方面的作用尚不清楚.
研究的目的:
- 评估红红素作为标准护理的辅助剂对严重病的败血症患者的败血症生物标志物和临床结果的影响.
- 作为主要终点,评估瘤亡因子 (TNF) / 介质素-10 (IL-10) 比率的变化.
- 检查包括其他生物标志物,血管压缩剂使用和28天死亡率在内的二次终点.
主要方法:
- 进行了一次单盲随机对照试验.
- 招募了110名危急败血症患者,其中55名在红红素组和55名在安慰剂组.
- 主要结局是从第0天到第6天血清TNF/IL-10比率的变化.
主要成果:
- 在败血症患者中,红素的添加并没有显著改变TNF/IL-10比率.
- 红红素 (51%) 和安慰剂 (47%) 组之间没有观察到28天死亡率的显著差异.
- 虽然红红素组的普罗卡尔西托尼 (PCT) 和C反应蛋白 (CRP) 降低,但只有PCT在安慰剂组下降. 不幸存者在第6天的TNF/IL-10比率较低.
结论:
- 红素,当添加到标准护理时,并没有证明对败血症患者的益/抗炎失衡或死亡率有有益影响.
- 这项研究表明,红色素不会调节主要的败血症生物标志物或改善该患者群体的临床结果.
- 可能需要进一步的研究来探索用于败血症管理的替代治疗策略.
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