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NEJM:镰状细胞特征可显著增加运动性横纹肌溶解症而非死亡的发生风险但

2016-08-04 MedSci MedSci原创

已有研究表明,镰状细胞特征可提高横纹肌溶解症和死亡的发生风险。本研究再次探究了镰状细胞特征与横纹肌溶解症和死亡之间的关系,控制已知的运动性横纹肌溶解症的危险因素,纳入大量已经实验室检查血红蛋白和接受运动性损伤预防措施的研究对象。 使用Cox比例风险模型来测试运动性横纹肌溶解和死亡是否会因镰状细胞特征状态而发生改变。研究共纳入47944名黑人现役士兵,已接受HbAs实验室检查。使用斯坦福军事数

已有研究表明,镰状细胞特征可提高横纹肌溶解症和死亡的发生风险。本研究再次探究了镰状细胞特征与横纹肌溶解症和死亡之间的关系,控制已知的运动性横纹肌溶解症的危险因素,纳入大量已经实验室检查血红蛋白和接受运动性损伤预防措施的研究对象。

使用Cox比例风险模型来测试运动性横纹肌溶解和死亡是否会因镰状细胞特征状态而发生改变。研究共纳入47944名黑人现役士兵,已接受HbAs实验室检查。使用斯坦福军事数据存储库,其中包含了所有现役士兵的综合医疗和管理数据。

结果发现,与无镰状细胞特征的士兵相比,镰状细胞特征士兵之间的死亡风险无明显差异,但是,镰状细胞特征与校正后较高的运动性横纹肌溶解症发生风险相关。且其作用效果的幅度与烟草使用与动性横纹肌溶解症发生风险之间的关联类似(与不使用烟草相比),且与BMI≥30相关(与BMI<25相比)。其效果小于最近使用的他汀类药物与动性横纹肌溶解症发生风险之间的关联(与未使用相比)。

总而言之,该研究发现,与无镰状细胞特征的人相比,镰状细胞特征并不会增加机体的死亡风险,但是却与运动性横纹肌溶解症的较高的发生风险相关。

原始出处:

D. Alan Nelson, et al., Sickle Cell Trait, Rhabdomyolysis, and Mortality among U.S. Army Soldiers. N Engl J Med 2016; 375:435-442August 4, 2016DOI: 10.1056/NEJMoa1516257.

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    2016-09-06 李东泽

    很好,不错,以后会多学习

    0

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    2016-09-06 李东泽

    很好,不错,以后会多学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1988713, encodeId=7fe71988e13d0, content=<a href='/topic/show?id=a93d63008da' target=_blank style='color:#2F92EE;'>#横纹肌溶解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63008, encryptionId=a93d63008da, topicName=横纹肌溶解)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ced3193, createdName=freve, createdTime=Mon Dec 26 08:40:00 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=112594, encodeId=816711259435, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Sep 06 20:54:00 CST 2016, time=2016-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=112584, encodeId=2ee51125840a, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Sep 06 20:53:00 CST 2016, time=2016-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483897, encodeId=e407148389ead, content=<a href='/topic/show?id=64e163009f2' target=_blank style='color:#2F92EE;'>#横纹肌溶解症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63009, encryptionId=64e163009f2, topicName=横纹肌溶解症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ecb97920606, createdName=ms1774076774505970, createdTime=Sat Aug 06 10:40:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615469, encodeId=ea01161546986, content=<a href='/topic/show?id=280196865f7' target=_blank style='color:#2F92EE;'>#镰状细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96865, encryptionId=280196865f7, topicName=镰状细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb4819654385, createdName=1508842480_96220443, createdTime=Sat Aug 06 10:40:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=96058, encodeId=092b9605831, content=军队的数据更庞大些。, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160824/IMG57BDA6843F0F38922.jpg, createdBy=8fdd1925645, createdName=1e0b9de5m54(暂无匿称), createdTime=Fri Aug 05 06:47:00 CST 2016, time=2016-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95998, encodeId=93db959987a, content=学习一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Aug 04 19:48:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1988713, encodeId=7fe71988e13d0, content=<a href='/topic/show?id=a93d63008da' target=_blank style='color:#2F92EE;'>#横纹肌溶解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63008, encryptionId=a93d63008da, topicName=横纹肌溶解)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ced3193, createdName=freve, createdTime=Mon Dec 26 08:40:00 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=112594, encodeId=816711259435, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Sep 06 20:54:00 CST 2016, time=2016-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=112584, encodeId=2ee51125840a, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Sep 06 20:53:00 CST 2016, time=2016-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483897, encodeId=e407148389ead, content=<a href='/topic/show?id=64e163009f2' target=_blank style='color:#2F92EE;'>#横纹肌溶解症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63009, encryptionId=64e163009f2, topicName=横纹肌溶解症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ecb97920606, createdName=ms1774076774505970, createdTime=Sat Aug 06 10:40:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615469, encodeId=ea01161546986, content=<a href='/topic/show?id=280196865f7' target=_blank style='color:#2F92EE;'>#镰状细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96865, encryptionId=280196865f7, topicName=镰状细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb4819654385, createdName=1508842480_96220443, createdTime=Sat Aug 06 10:40:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=96058, encodeId=092b9605831, content=军队的数据更庞大些。, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160824/IMG57BDA6843F0F38922.jpg, createdBy=8fdd1925645, createdName=1e0b9de5m54(暂无匿称), createdTime=Fri Aug 05 06:47:00 CST 2016, time=2016-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95998, encodeId=93db959987a, content=学习一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Aug 04 19:48:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1988713, encodeId=7fe71988e13d0, content=<a href='/topic/show?id=a93d63008da' target=_blank style='color:#2F92EE;'>#横纹肌溶解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63008, encryptionId=a93d63008da, topicName=横纹肌溶解)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ced3193, createdName=freve, createdTime=Mon Dec 26 08:40:00 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=112594, encodeId=816711259435, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Sep 06 20:54:00 CST 2016, time=2016-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=112584, encodeId=2ee51125840a, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Sep 06 20:53:00 CST 2016, time=2016-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483897, encodeId=e407148389ead, content=<a href='/topic/show?id=64e163009f2' target=_blank style='color:#2F92EE;'>#横纹肌溶解症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63009, encryptionId=64e163009f2, topicName=横纹肌溶解症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ecb97920606, createdName=ms1774076774505970, createdTime=Sat Aug 06 10:40:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615469, encodeId=ea01161546986, content=<a href='/topic/show?id=280196865f7' target=_blank style='color:#2F92EE;'>#镰状细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96865, encryptionId=280196865f7, topicName=镰状细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb4819654385, createdName=1508842480_96220443, createdTime=Sat Aug 06 10:40:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=96058, encodeId=092b9605831, content=军队的数据更庞大些。, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160824/IMG57BDA6843F0F38922.jpg, createdBy=8fdd1925645, createdName=1e0b9de5m54(暂无匿称), createdTime=Fri Aug 05 06:47:00 CST 2016, time=2016-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95998, encodeId=93db959987a, content=学习一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Aug 04 19:48:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
    2016-08-05 1e0b9de5m54(暂无匿称)

    军队的数据更庞大些。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1988713, encodeId=7fe71988e13d0, content=<a href='/topic/show?id=a93d63008da' target=_blank style='color:#2F92EE;'>#横纹肌溶解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63008, encryptionId=a93d63008da, topicName=横纹肌溶解)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ced3193, createdName=freve, createdTime=Mon Dec 26 08:40:00 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=112594, encodeId=816711259435, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Sep 06 20:54:00 CST 2016, time=2016-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=112584, encodeId=2ee51125840a, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Tue Sep 06 20:53:00 CST 2016, time=2016-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483897, encodeId=e407148389ead, content=<a href='/topic/show?id=64e163009f2' target=_blank style='color:#2F92EE;'>#横纹肌溶解症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63009, encryptionId=64e163009f2, topicName=横纹肌溶解症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ecb97920606, createdName=ms1774076774505970, createdTime=Sat Aug 06 10:40:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615469, encodeId=ea01161546986, content=<a href='/topic/show?id=280196865f7' target=_blank style='color:#2F92EE;'>#镰状细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96865, encryptionId=280196865f7, topicName=镰状细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb4819654385, createdName=1508842480_96220443, createdTime=Sat Aug 06 10:40:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=96058, encodeId=092b9605831, content=军队的数据更庞大些。, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160824/IMG57BDA6843F0F38922.jpg, createdBy=8fdd1925645, createdName=1e0b9de5m54(暂无匿称), createdTime=Fri Aug 05 06:47:00 CST 2016, time=2016-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95998, encodeId=93db959987a, content=学习一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Aug 04 19:48:00 CST 2016, time=2016-08-04, status=1, ipAttribution=)]
    2016-08-04 1dd8c52fm63(暂无匿称)

    学习一下!

    0

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