药理干预措施预防急性山病的比较效果:系统性审查和贝叶斯网络元分析
Junyan Wang1, Nan Lian2, Kuo Tang1
1Department of Anesthesiology, Laboratory of Mitochondrial Metabolism and Perioperative Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
中等剂量的乙胺有效地预防急性山病 (AMS) 长达5天. 没有药物能够有效地预防严重的AMS,这凸显了进一步研究的必要性.
科学领域:
- 高度医学 高度医学
- 药理学 药理学是指药理学的学科.
- 预防医学 预防医学
背景情况:
- 急性山病 (AMS) 是高海拔地区最常见的疾病.
- 增加的旅游和职业活动需要有效的AMS预防.
- 目前对AMS的药理学预防缺乏比较数据和剂量优化.
研究的目的:
- 为了比较13种药物预防AMS和严重AMS (SAMS) 的疗效.
- 评估药理干预对路易斯湖得分 (LLS),SpO2和肺动脉压 (PAP) 的影响.
- 根据剂量和持续时间来确定AMS药物的最佳预防窗口.
主要方法:
- 28项随机对照试验 (RCT) 的网络元分析 (NMA) 涉及到快速爬升到>2500m.
- 对AMS发生率,SAMS发生率,LLS,SpO2和PAP的药物疗效评估.
- 使用Cochrane偏差风险和CINeMA进行质量评估;用于"时间"和"高度"窗口的网络元回归.
主要成果:
- 乙胺250 mg两次显示AMS的5天的预防窗口; 375 mg两次显示3天的窗口.
- 德克萨米他4毫克两次和伊布洛芬600毫克三次也减少了AMS的发生率.
- 没有药物降低了SAMS发病率;西尔德纳菲尔减弱了高度引起的PAP升高.
结论:
- 中等剂量的乙胺 (125-250毫克两次) 提供有效的AMS预防,持续时间比高剂量疗法更长.
- 目前没有药理干预有效地预防SAMS或高海拔诱导的PAP升高.
- 进一步进行高质量的临床试验对于推进AMS预防策略至关重要.
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