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J INTERN MED:乙酰水杨酸与细菌性肺炎球菌性肺炎患者生存率有关

2022-03-25 MedSci原创 MedSci原创

细菌性肺炎球菌性肺炎入院时使用乙酰水杨酸可显著降低患者诊断后长达一年的死亡率。肺炎和其他感染综合征患者的乙酰水杨酸治疗值得进一步研究。

肺炎通常由肺炎链球菌(肺炎球菌)引起,并与随后的心血管并发症和死亡率增加有关。肺炎球菌性肺炎之前常伴有上呼吸道感染。通常以突发短期寒战开始,紧接着,一般出现发烧,呼吸时患侧疼痛(胸膜炎), 咳嗽,呼吸困难及咳痰。在肺炎病程中使用乙酰水杨酸治疗的潜在短期生存益处仍然存在争议,并且尚未研究探究接受乙酰水杨酸治疗的肺炎患者的长期结局。

近日,内科学领域权威杂志Journal of Internal Medicine上发表一篇研究文章,该研究旨在评估乙酰水杨酸的使用与细菌性肺炎球菌性肺炎患者长达一年的生存率之间的关联。

研究人员审查了1975-2019年期间冰岛的所有细菌性肺炎球菌事件。研究队列由至少18岁的个体组成,其症状和影像学结果与肺炎一致。研究人员使用倾向评分加权(逆概率加权)在30天、90天和1年评估了肺炎患者存活率的差异。由于不成比例,研究人员对受试者30天生存期进行了7天生存期的拆分和分层。

该研究总共确定了815例细菌性肺炎球菌性肺炎事件(中位年龄为67岁,女性为48%)。研究人员使用倾向评分加权对乙酰水杨酸治疗与30天生存率的关联进行Cox回归分析,显示平均风险比(HR)为0.60(95%CI为0.34-1.05)。在7天内观察到显著改善的存活率(HR=0.42,95%CI为0.19-0.92),但在7-30天内没有观察到(HR=1.08,95%CI为0.46-2.55)。乙酰水杨酸与90天(HR=0.53,95%CI为0.32-0.87)和一年(HR=0.48,95%CI为0.31-0.75)的生存率相关。

由此可见,细菌性肺炎球菌性肺炎入院时使用乙酰水杨酸可显著降低患者诊断后长达一年的死亡率。肺炎和其他感染综合征患者的乙酰水杨酸治疗值得进一步研究。

原始出处:

Kristján Godsk Rögnvaldsson,et al.Acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: A long-term nationwide study.Journal of Internal Medicine.2022.https://onlinelibrary.wiley.com/doi/10.1111/joim.13485

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在结直肠癌诊断后的早期,MS患者的总体和癌症特异性生存率较低。需要进一步研究以确定哪些因素可能导致这些糟糕的结局。

J Thromb Haemost:院前抗血小板治疗与COVID-19住院患者生存率之间的关联

这项迄今为止对COVID-19患者进行院前抗血小板治疗的最大规模观察性研究结果表明其与院内死亡率显著降低有关。

JAHA:神经激素阻断与甲状腺素运载蛋白心脏淀粉样变性患者生存率无关

使用神经激素阻滞剂与转甲状腺素蛋白心脏淀粉样变性患者的存活率无关。对于整个队列,停用βB治疗可能与提高患者生存率有关。但需要更多的研究来证实这些结果。

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