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Heart:肺部超声引导疗法可减少慢性心衰患者急性失代偿事件

2020-06-24 MedSci原创 MedSci原创

LUS指导的治疗降低了慢性HF门诊患者随访期间ADHF的住院率。

心力衰竭(HF)患者肺充血是住院的主要原因。肺部超声(LUS)是识别亚临床肺充血的有用工具。近日,心脏病领域权威杂志Heart上发表了一篇研究文章,研究人员旨在评估了除了体格检查(PE)之外,LUS在HF患者门诊管理中的效用。

在这项随机、多中心、无盲的研究中,研究人员将慢性HF和优化药物治疗的患者随机分为两组:“PE+LUS”组接受PE和LUS,以及“PE only”组。分别根据LUS的结果和PE对利尿疗法进行了调整。该研究的主要终点是在90天随访期间急性失代偿性心力衰竭(ADHF)的住院率降低情况。次要终点是90天随访时NT-proBNP水平、生活质量测试(QLT)和心脏死亡率降低。

该研究共有244例慢性HF和优化药物治疗的患者入选,并随机分为接受PE和LUS的“PE+LUS”组和仅接受PE的“PE only”组。研究期间共发生了37项主要终点事件。“PE+LUS”组在90天时的ADHF住院率显著降低(9.4% vs. 21.4%;相对风险=0.44;95%CI为0.23至0.84;p=0.01),ADHF住院风险降低了56%(p=0.01),需要治疗的患者人数为8.4(95%CI为4.8至34.3)。在第90天,“PE+LUS”组患者的NT-proBNP水平和QLT得分显著降低,而“PE only”组的NT-proBNP水平和QLT得分均升高。两组之间的死亡率没有差异。

由此可见,LUS指导的治疗降低了慢性HF门诊患者随访期间ADHF的住院率。

原始出处:

Claudia Marini.et al.Lung ultrasound-guided therapy reduces acute decompensation events in chronic heart failure.heart.2020.http://dx.doi.org/10.1136/heartjnl-2019-316429

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    2020-06-26 zhaojie88
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    2020-06-26 slcumt
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    2020-06-25 牛顿爱吃苹果

    学习了

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