阻断 ангиотензин转化酶是膝关节全关节整形术后周围假肢关节感染的潜在危险因素
Rishi Trikha1, Nicolas Cevallos2, Alan L Zhang2
1Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
Arthroplasty today
|March 17, 2025
概括
服用血管激素转化酶抑制剂 (ACEis) 的患者在全膝关节整形术 (TKA) 后,与服用血管激素受体阻断剂 (ARB) 患者相比,患上周围假肢关节感染 (PJI) 的比例更高. 使用ACEi可能是PJI的可修改风险因素.
科学领域:
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 周围假肢关节感染 (PJI) 是膝关节全关节整形术 (TKA) 后的一个重大并发症.
- 活体内研究表明,血管激素转化酶抑制剂 (ACEis) 可能具有免疫抑制性质.
- 使用ACEi对TKA结局的临床影响需要进一步调查.
研究的目的:
- 调查ACEi使用与TKA后PJI风险之间的关联.
- 为了比较服用ACE的患者中的PJI率与血管激素受体抑制剂 (ARBs) 相比.
- 为了确定TKA后手术后感染的潜在可修改的风险因素.
主要方法:
- 对"海军潜水者珍珠潜水者"国家登记册的回顾性分析.
- 在TKA之前至少一年接受ACEis或ARB的患者的倾向性得分匹配.
- 使用灌和脱bridement和/或假肢移除的程序代码识别PJI病例.
主要成果:
- 在匹配后,在每个组中分析了39103名患者 (ACEi与ACEi对比). 这是一个ARB).
- 在TKA后的6个月 (OR:2.69) 和1年 (OR:2.94) 中,ACEi组的PJI率显著更高.
- 在90天内,在ACEi组中也观察到深静脉血栓,肺栓塞,肺炎,血瘤和输血的风险增加.
结论:
- 与ARB相比,外科手术期间使用ACEi与TKA后PJI的发生率相对较高.
- 由于ACEi具有潜在的免疫抑制作用,因此需要进一步研究以了解其潜在机制.
- 在TKA患者中,ACEi治疗可能是术前感染的低估,可修改的风险因素.
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