进子抑制剂在食道水结合后的使用及其对临床结果的影响:TrinetX全球合作网络的现实数据
Nisar Amin1, Harleen Chela2, Muhammad Faisal Mubarak3
1Department of Internal Medicine, Charleston Area Medical Center, Charleston, WV 25304, USA.
Diagnostics (Basel, Switzerland)
|July 12, 2025
概括
在内静脉结术 (EVL) 后的质子抑制剂 (PPI) 不能预防肝硬化患者的出血. 使用PPI与不良事件和死亡率的风险增加有关,建议重新考虑常规使用.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 临床药理学 临床药理学
背景情况:
- 质子抑制剂 (PPI) 是常见的处方后内镜静脉结 (EVL) 预防出血.
- 在这种情况下,关于PPI有效性和安全性的证据是混合的,在肝硬化患者中存在潜在风险.
研究的目的:
- 评估PPI在选择性EVL之后用于肝硬化和食道静脉瘤患者的初级预防的结果.
- 评估PPI对出血事件和不良事件的影响.
主要方法:
- 使用 TriNetX 全球健康研究网络进行的回顾性队列研究.
- 在EVL后至少两周接受PPI的患者与在一个月内不接受PPI的患者进行了比较.
- 倾向性得分匹配用于平衡队列,以分析4周和8周的结果.
主要成果:
- 使用PPI与4周或8周食道出血减少无关.
- 在4周和8周的PPI组中观察到明显更高的复合不良事件率.
- 使用PPI与肝脏脑病变和急性损伤 (AKI) 的增加有关,在8周后死亡率更高.
结论:
- 在肝硬化患者预防性EVL后常规使用PPI并不能降低出血风险.
- PPI与不良事件的显著增加有关,包括AKI和肝脏脑病变.
- 在EVL之后用于初级预防的PPI的常规使用需要重新考虑.
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