增强营养支持可能改善与里瓦洛克萨班相关的功能迅速下降:来自现实世界的研究的新见解
Cheng Meng1, Linjie Li2, Ying Han2
1Department of Nephrology, Kidney Disease Medical Center, General Hospital, Tianjin Medical University, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, People's Republic of China.
Drug design, development and therapy
|December 10, 2025
概括
与华法林相比,里瓦罗克萨班增加了快速功能下降的风险. 改善营养状况可能有助于减少服用里瓦洛克萨班的患者这种不良影响.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- 抗凝剂治疗对于预防血栓事件至关重要.
- 华法林和里瓦洛克萨班是常见的抗凝药.
- 在需要抗凝药的患者中,功能下降是一个重大问题.
研究的目的:
- 为了比较与里瓦洛克萨班和华法林治疗的患者之间的快速功能下降的发生率.
- 为了研究预后营养指数 (PNI) 与接受里瓦洛克萨班治疗的患者功能下降之间的关联.
主要方法:
- 来自天津健康和医疗数据平台的8842名患者的回顾性分析.
- 使用后勤模型,治疗权重的逆概率 (IPTW) 和倾向性得分匹配 (PSM) 分析对快速功能下降的比较.
- 多变量分数多项式相互作用 (MFPI) 和受限立方线 (RCS) 用于评估PNI得分的影响.
主要成果:
- 与华法林相比,里瓦罗克萨班与快速功能下降的风险明显高 (OR,1.17;95% CI,1.07-1.29).
- 这种关联在单变量,多变量,IPTW,PSM和子组分析中持续存在.
- 增加PNI得分与迅速功能下降的风险降低有关,特别是在接受里瓦洛克萨班的患者中.
结论:
- 与华法林相比,里瓦罗克萨班与快速功能下降的风险增加有关.
- 由PNI指出的提高营养状况的策略可以减轻这种风险.
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