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肝硬化患者上部胃肠道出血中的特兰胺酸:一项随机对照试验

Manoj Kumar¹, Shantan Venishetty¹, Ankur Jindal¹

¹Department of Hepatology and Liver Transplantation, Institute of Liver & Biliary Sciences, New Delhi, India.

Hepatology (Baltimore, Md.)

|March 5, 2024

概括

特兰胺酸有效治疗晚期肝硬化患者上部胃肠道出血. 它在第五天显著减少出血和重新出血,特别是来自食道的水绑定部位.

科学领域:

胃肠病学胃肠病学
肝病学肝病学是一种肝病学.
药理学药理学是指药理学的学科.

背景情况:

患有晚期肝硬化 (Child-Turcotte-Pugh类B/C) 的患者经历上部胃肠道出血 (UGIB),表现出系统性和局部性纤维素分解.
局部纤维解发生在食道和胃粘膜中.

研究的目的:

评估特兰胺酸在治疗肝硬化患者急性UGIB时的疗效和安全性.
确定特兰胺酸是否可以减少这种患者群体的治疗失败和再出血.

主要方法:

一项随机对照试验,涉及600名患有晚期肝硬化 (Child-Turcotte-Pugh B或C级) 和UGIB的患者.
患者被分配给接受三胺酸 (n=300) 或安慰剂 (n=300).
主要结局是5天治疗失败;次要结局包括从食道水绑定部位 (EVL) 出血和死亡率.

主要成果:

到第五天治疗失败发生在6.3%的特兰胺酸组,而安慰剂组的失败率为13.3% (P=0.006).
到第5天,EVL部位的出血在与安慰剂 (12.0%) (P=0.005) 相比,在三胺酸组 (4.9%) 显着较低.
在tranexamic acid和安慰剂组之间,5天和6周的死亡率相似.

结论:

在患有晚期肝硬化和UGIB的患者中,三胺酸在第五天显著减少了治疗失败.
该药物有效地防止在第5天和第6周之间从EVL部位重新出血.
特兰胺酸显示出有利的安全性,死亡率与安慰剂相似.

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