在ALS患者在家庭早期启动NIV后与存活相关的因素
Thomas Réginault1,2, P Wibart3,4, S Mathis5
1Département de Médecine, Service de Réanimation Médicale, Hôpital Pellegrin, Bordeaux, France. thomas.reginault@chu-bordeaux.fr.
早期的非侵入性通风 (NIV) 使用每天超过5小时的肌缩侧面硬化症 (ALS) 患者与改善的生存率有关. 坚持NIV治疗对于改善ALS治疗的预后至关重要.
科学领域:
- 神经学 神经学
- 肺部病理学 肺部病理学
- 医疗技术 医疗技术 医学技术
背景情况:
- 在肌缩侧面硬化症 (ALS) 中早期启动非侵入性通风 (NIV) 需要平衡患者的耐受性和治疗的有效性.
- 建立一个明确的NIV策略,包括坚持目标和事件纠正,对于ALS患者的管理至关重要.
研究的目的:
- 为了确定与改善ALS患者的存活率相关的因素,在开始在家治疗NIV一个月后.
- 调查NIV坚持 (ADH),治疗质量和设备参数对患者存活时间的影响.
主要方法:
- 一项回顾性研究分析了在2017年9月至2021年6月期间开始NIV的184名ALS患者.
- 在纳入后至少两年收集数据,重点关注基线特征,NIV参数和早期NIV启动期间的监测.
- 主要结局是死亡风险;次要结局包括NIVADH与预后的关联,并确定ADH切断点以预测生存.
主要成果:
- 在分析的队列 (178名患者) 中,NIV治疗质量和设备设置没有显著影响预后.
- 较低对NIV的坚持与死亡风险增加有显著的关联.
- 在早期开始阶段每天使用NIV超过5小时与死亡风险降低相关 (HR=0.4,95%CI:0.27-0.9).
结论:
- 在治疗的早期阶段,每天使用NIV超过5小时,与ALS患者的生存率提高有关.
- 早期坚持和足够的NIV使用时间是改善ALS患者接受通风治疗的预后的关键因素.
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