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NEJM:美托洛尔不能预防COPD患者加重恶化

2019-10-22 MedSci MedSci原创

在中度或重度慢性阻塞性肺病患者中,美托洛尔无法降低慢性阻塞性肺病患者的第一次加重恶化风险

观察研究表明,β-受体阻滞剂可能降低中重度慢性阻塞性肺疾病(COPD)患者的恶化和死亡风险,但这些发现尚未在随机试验中得到证实。

在这一前瞻性随机试验中,年龄在40至85岁之间的COPD患者分配给β受体阻滞剂(缓释美托洛尔)或安慰剂。患者均有慢性阻塞性肺病(COPD)的临床病史,同时有中度气流限制和加重的风险。研究的主要终点是治疗期间COPD第一次加重。

532例患者,平均年龄为65.0,1秒用力呼气量(FEV 1) 41.1%。研究发现,与安慰剂相比,美托洛尔组在第一次发作的中位时间无显著性差异,美托洛尔组为202天,安慰剂组为222天(HR 1.05),而且美托洛尔住院风险增加(危险比1.91)。治疗期间,美托洛尔组有11例死亡,安慰剂组有5例死亡。

在中度或重度慢性阻塞性肺病患者中,美托洛尔无法降低慢性阻塞性肺病患者的第一次加重恶化风险。

原始出处:

Mark T. Dransfield et al. Metoprolol for the Prevention of Acute Exacerbations of COPD. N Engl J Med, October 20, 2019.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1337147, encodeId=be68133e1476f, content=<a href='/topic/show?id=428fe9954c0' target=_blank style='color:#2F92EE;'>#美托洛尔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79954, encryptionId=428fe9954c0, topicName=美托洛尔)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/FGFAawy0kQNXbuvUuLtUVrx5aKhOIkwqJwyxu0QlpLFIDSb1Ht19ptXvYBjuAoNBubibnNF3iazdpico7gJlbBVQg/132, createdBy=edaf2500125, createdName=ms3892185887221420, createdTime=Thu Oct 24 09:20:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1488847, encodeId=a60b148884e6c, content=<a href='/topic/show?id=69675090ca' target=_blank style='color:#2F92EE;'>#COPD患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5090, encryptionId=69675090ca, topicName=COPD患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852e8475198, createdName=gous, createdTime=Thu Oct 24 09:20:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374299, encodeId=0f6e3e429981, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Wed Oct 23 18:25:53 CST 2019, time=2019-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374270, encodeId=03383e42704b, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Wed Oct 23 05:17:44 CST 2019, time=2019-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034992, encodeId=54db1034992dd, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Oct 22 21:20:00 CST 2019, time=2019-10-22, status=1, ipAttribution=)]
    2019-10-24 gous
  3. [GetPortalCommentsPageByObjectIdResponse(id=1337147, encodeId=be68133e1476f, content=<a href='/topic/show?id=428fe9954c0' target=_blank style='color:#2F92EE;'>#美托洛尔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79954, encryptionId=428fe9954c0, topicName=美托洛尔)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/FGFAawy0kQNXbuvUuLtUVrx5aKhOIkwqJwyxu0QlpLFIDSb1Ht19ptXvYBjuAoNBubibnNF3iazdpico7gJlbBVQg/132, createdBy=edaf2500125, createdName=ms3892185887221420, createdTime=Thu Oct 24 09:20:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1488847, encodeId=a60b148884e6c, content=<a href='/topic/show?id=69675090ca' target=_blank style='color:#2F92EE;'>#COPD患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5090, encryptionId=69675090ca, topicName=COPD患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852e8475198, createdName=gous, createdTime=Thu Oct 24 09:20:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374299, encodeId=0f6e3e429981, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Wed Oct 23 18:25:53 CST 2019, time=2019-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374270, encodeId=03383e42704b, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Wed Oct 23 05:17:44 CST 2019, time=2019-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034992, encodeId=54db1034992dd, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Oct 22 21:20:00 CST 2019, time=2019-10-22, status=1, ipAttribution=)]
    2019-10-23 一个字-牛

    学习了谢谢分享

    0

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    2019-10-23 thm112988

    0

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    2019-10-22 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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