低分子量肝素加胰岛素治疗高甘油三性急性胰腺炎:一项随机临床试验
Wenhua He1, Ling Ding1, Zhijun Liu2
1Department of Gastroenterology, First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
JAMA network open
|November 7, 2025
概括
将低分子量肝素 (LMWH) 添加到胰岛素并没有改善过高甘油性急性胰腺炎的结果. 这表明,在这些患者中,LMWH可能不需要用于早期的脂质降低.
科学领域:
- 临床医学 临床医学
- 胃肠病学 胃肠病学
- 内分泌学 在内分泌学.
背景情况:
- 过高甘油性急性胰腺炎 (HTG-AP) 是一种严重的疾病,通常用胰岛素治疗降脂.
- 在HTG-AP中,肝素,特别是低分子量肝素 (LMWH) 与胰岛素的附加益处仍然不确定.
研究的目的:
- 为了确定与胰岛素结合LMWH是否在HTG-AP患者中提供优越的临床结果,而不是单独胰岛素.
主要方法:
- 一个多中心的,开放的,随机的优越性试验,涉及533名HTG-AP患者.
- 参与者接受了皮下LMWH加胰岛素或单独胰岛素治疗3天.
- 主要终点是30天内新发器官衰竭和/或全因死亡率的复合结果.
主要成果:
- 在LMWH加胰岛素组 (25.0%) 和单独胰岛素组 (28.3%) (RR,0.89;P=.40) 之间的初级终点没有显著差异.
- 两组人都以相似的方式达到目标甘油三水平.
- 安全结果,包括出血和不良事件,在两组之间是可比的.
结论:
- 在治疗HTG-AP时,LMWH和胰岛素的组合并没有显示出比单独胰岛素更高的疗效.
- 在患有HTG-AP的患者中,LMWH可能不是早期降脂治疗的必要组成部分.
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