德斯莫普林素对透术后脏功能减弱患者出血并发症的影响:一项随机对照试验
Uttayan Chakrabarti1, Rajesh Jhorawat1, Nitin Kumar Bajpai1
1Department of Nephrology, All India Institute of Medical Sciences (AIIMS), Jodhpur.
Kidney360
|March 11, 2025
概括
在功能受损的患者中,德斯摩素没有减少活检后的出血并发症. 这项研究发现,在德斯莫普列辛和安慰剂组之间,出血事件或血液瘤大小没有显著差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内部医学 内部医学
- 临床试验 临床试验
背景情况:
- 经过脏活检后经常出现出血并发症,特别是在功能受损的患者 (eGFR ≤60毫升/分钟/1.73米2) 中.
- 了解减轻出血风险的干预措施对于患者安全至关重要.
研究的目的:
- 评估德斯莫普林素在降低出血并发症后的疗效,进行脏活检.
- 评估德斯莫普林素对周血液瘤大小在功能减弱的患者的影响.
主要方法:
- 一个双盲,随机对照试验与152名患者进行.
- 患者在活检前一小时接受了鼻内德斯莫普林素 (3毫克/千克) 或液安慰剂.
- 流血并发症和围血瘤大小 (超声波) 分别是主要和次要结局.
主要成果:
- 总体出血并发症发生在42%的患者中 (36%的德斯莫普雷辛与47%的对照),不显著的差异 (p=0.17).
- 活检后6小时和24小时内血液瘤的中位数大小在两组之间是相似的 (p>0.05).
- 虽然周围瘤的发生频率在6小时后是相似的,但在24小时后的德斯摩辛组 (19%对36%,p=0.02) 频率较低.
结论:
- 切除前使用德斯莫普林素并不能显著降低患有功能减弱的患者的出血并发症.
- 在脏活检后6小时或24小时内,德斯摩普林素没有减少周围血瘤体积.
- 可能需要进一步的研究来探索在这个患者群体中预防出血的替代策略.
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