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Crit Care Med:预先钙通道抑制剂使用可降低重症脓毒症患者死亡率?

2017-04-06 安雅晶;吴星 环球医学

2017年3月,发表在《Crit Care Med》的一项由荷兰科学家进行的前瞻性观察性研究表明,预先使用钙通道抑制剂与重症脓毒症患者死亡率降低相关。目的:实验性研究表明,钙通道抑制剂可以改善脓毒症患者结局。本研究的目的是考察预先使用钙通道抑制剂与ICU脓毒症患者结局之间的相关性。


2017年3月,发表在《Crit Care Med》的一项由荷兰科学家进行的前瞻性观察性研究表明,预先使用钙通道抑制剂与重症脓毒症患者死亡率降低相关。

目的:实验性研究表明,钙通道抑制剂可以改善脓毒症患者结局。本研究的目的是考察预先使用钙通道抑制剂与ICU脓毒症患者结局之间的相关性。

设计:前瞻性观察研究。

地点:荷兰2家三级护理医院ICU病房。

患者:共分析了1060例连续的脓毒症患者,其中18.6%的患者使用钙通道抑制剂。

干预:无。

测量和主要结果:鉴于钙通道抑制剂使用者与非使用者之间基线差异较大,建立倾向性评分匹配队列,阐释使用钙通道抑制剂的差异可能性。测量入院后最初4天内,15种血清生物标记物的水平,这些标记物为脓毒症发病机制相关宿主应答提供关键启示。两组前24h的疾病严重程度、感染位置和病原体相似。在倾向性匹配队列(20.2% vs 32.9%不使用钙通道抑制剂者;p=0.009)和多变量分析中(比值比,0.48;95% CI,0.31~0.74;p=0.0007),预先钙通道抑制剂的使用与30天生存率改善相关。除了钙通道抑制剂使用者的抗凝血酶水平有较少下降外,预先钙通道抑制剂使用与细胞因子网络、血管内皮细胞和凝血系统活化的宿主标记物指示水平变化不相关。

结论:预先钙通道抑制剂使用与ICU脓毒症患者死亡率降低相关。

原始出处:

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    2017-07-09 jklm09
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