在患有甲状腺风暴的患者中,Beta-1选择性β-阻断剂与普罗普兰诺洛尔的临床疗效:一项回顾性队列研究
Yuichiro Matsuo1, Taisuke Jo2, Hideaki Watanabe1
1Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan.
Critical care medicine
|March 29, 2024
概括
在治疗甲状腺风暴时,Beta-1选择性β-抑制剂和propranolol显示出类似的住院死亡率. 这项研究表明,无论心力衰竭状态如何,这两种β-阻断剂类型都是甲状腺风暴管理的可行选择.
科学领域:
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 甲状腺风暴是一种严重的甲状腺毒理症的表现,可以用β-抑制剂治疗.
- 普罗普兰诺洛尔在历史上是首选的,但2016年的指导方针建议使用β-1选择性剂.
- 支持指导方针转变的证据有限.
研究的目的:
- 在甲状腺风暴患者的住院死亡率的调查,基于β-阻断剂的选择.
- 比较β-1选择性β-阻断剂和propranolol之间的结果.
主要方法:
- 使用日本诊断程序组合数据库进行回顾性队列研究.
- 包括从2010年4月到2022年3月因甲状腺风暴住院的患者.
- 倾向性评分重叠权重和小组分析急性心力衰竭.
主要成果:
- 在2462名患者中,1452人接受了β-1选择性药物,1010人接受了propranolol.
- 调整后的住院死亡率与此相似:选择性β-1的6.3%,与兰醇的7.4%相比 (OR,0.85;95% CI,0.57-1.26)).
- 在急性心力衰竭患者中,死亡率没有显著差异.
结论:
- 在影响甲状腺风暴的住院死亡率方面,Beta-1选择性β-阻断剂和普拉诺洛尔没有显著差异.
- 无论是β-1选择性剂还是普拉诺洛尔都是可行的治疗选择.
- 治疗选择应基于个体的临床背景.
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