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在败血症相关的血小板缺血中Avatrombopag和血小板恢复:回顾性观察性队列研究
Nengxian Shi1, Jin He1, Qian Xu1
1Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University-Guangzhou, Guangzhou, China.
在患有败血症相关血小板缺血症 (SAT) 的重症患者中,Avatrombopag改善了延迟的血小板恢复. 然而,这并没有改善存活率,并且与更长的ICU停留有关,没有增加出血风险.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 败血症相关的血小板缺血 (SAT) 在重症患者中很常见,与更糟糕的结果有关.
- 目前的治疗方法,如血小板输血,提供有限的益处.
- 在SAT中,对血栓形成素受体激动剂的证据很少.
研究的目的:
- 评估AVATROMBOPAG对SAT重症患者血小板恢复的影响.
- 评估阿瓦特罗姆波帕格对临床结果和安全性的影响.
主要方法:
- 追溯观察队列研究256名成年ICU患者的SAT.
- 基于倾向分数的治疗权重的逆概率 (IPTW) 用于混.
- 主要结局:血小板在第14天恢复;次要:早期恢复,死亡率,ICU停留.
主要成果:
- 阿瓦特罗姆波帕格的使用与14日 (或3.58) 血小板恢复的几率更高有关.
- 对早期血小板恢复 (第7天,10天) 或28天死亡率没有显著的益处.
- 类似的出血/血栓事件,但更长的ICU停留时间与avatrombopag.
结论:
- 在SAT患者中,Avatrombopag改善了延迟的血小板恢复,而不会增加血栓或出血风险.
- 血液学上的好处并没有转化为更好的生存率.
- 长时间的ICU停留与使用avatrombopag有关.
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