慢性肢体威胁性缺血患者的临床结果
Taira Kobayashi1, Kazuki Mukai2, Yuichiro Katayama2
1Department of Cardiovascular Surgery, JA Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi-shi, Hiroshima 738-8503, Japan.
Annals of vascular surgery
|September 5, 2025
概括
在慢性肢体威胁性缺血 (CLTI) 患者中,使用10种或更多处方药的超多药性与更糟糕的结果有关. 这项研究发现,高多药性患者在重新血管化后的生存率和肢体挽救率显著降低.
科学领域:
- 血管外科
- 老年医学
- 临床药理学
背景情况:
- 在老年患者中,多种药物越来越令人担忧,与不良结果有关.
- 慢性肢体威胁性缺血 (CLTI) 患者通常有多种并发症,需要多种药物治疗.
- 超多药对接受再血管化的CLTI患者的影响尚不清楚.
研究的目的:
- 研究重血管化后的CLTI患者的高多药性和临床结果之间的关联.
- 确定影响患者生存的危险因素.
- 为了比较超多药剂患者和无多药剂患者之间的结果.
主要方法:
- 在2014年至2022年间接受CLTI重血管化的患者的回顾性评估.
- 分类为没有多药性 (NHP,<10种药物) 和多药性 (HP,≥10种药物) 组.
- 使用卡普兰-梅尔和多变量分析的整体生存率,心血管死亡率和肢体挽救率的分析.
主要成果:
- 在417名患者中,多药组占53%,中位数为10种药物.
- 与NHP组相比,HP患者的整体存活率明显较低 (P< 0. 001).
- 在HP组中,无心血管死亡 (P < 0. 001) 和肢体挽救 (P = 0. 010) 也减少;高多药性是死亡的独立预测因子 (HR, 1. 60).
结论:
- 超多药性与CLTI患者的整体存活期有负面关联.
- 心血管死亡和肢体救援的减少是这种队列中超多药性的重要后果.
- 临床治疗策略应考虑CLTI患者的药物负担,以改善结果.
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