非选择性β抑制剂与肝硬化重症患者的死亡率降低有关:一项现实研究
Rahul Kumar1,2,3, Su Lin1,4, Gautam Mehta1,5
1Liver Failure Group, UCL Institute for Liver and Digestive Health, UCL Medical School, London, UK.
Alimentary pharmacology & therapeutics
|August 2, 2024
概括
非选择性β-阻断剂 (NSBB) 改善了急性肝硬化失补偿 (AD) 严重病患者的存活率. 这可能是由于NSBB抑制了炎症反应,降低了死亡率.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 非选择性β抑制剂 (NSBB) 通过调节炎症反应,可能有利于患有肝硬化急性失补偿 (AD) 的患者.
- 该研究评估了NSBB对入住ICU的AD患者死亡率和炎症的影响.
研究的目的:
- 评估入院前非选择性β-阻断剂 (NSBB) 使用对急性肝硬化不补偿 (AD) 需要接受ICU治疗的患者28天死亡率的影响.
- 调查NSBB对该患者队列中的全身炎症标记物的影响.
主要方法:
- 对216名患有需要ICU入院的AD患者 (108名NSBB用户,108名对照) 进行了 propensity score-matched (PSM) 分析.
- 在NSBB和非NSBB组之间比较了关键的临床参数,炎症标志物 (WCC,NLR,CRP) 和28天死亡率.
主要成果:
- 在入住ICU时,NSBB组表现出较低的心率,血小板,白细胞计数 (WCC),中性粒细胞与淋巴细胞的比率 (NLR) 和C反应蛋白 (CRP).
- 接受NSBB治疗的患者的28天和90天死亡率明显降低.
- 在非NSBB组中,社区获得的细菌感染,功能衰竭和更高的急性与慢性肝功能衰竭 (ACLF) 等级更为普遍.
结论:
- 之前使用非选择性β抑制剂 (NSBB) 与急性失补偿症 (AD) 严重肝硬化患者的生存率改善有关.
- NSBB对死亡率的有益影响很可能是由系统性炎症反应的减弱介导的.
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