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J Gastroenterology:治疗顽固性腹水可以减轻肌肉质量的减少并提高失代偿期肝硬化患者的生存率

2019-09-18 不详 MedSci原创

本研究探究了缬沙坦治疗对袢利尿剂和醛固酮拮抗剂无反应的顽固性腹水患者骨骼肌体积的变化。

背景
本研究探究了缬沙坦治疗对袢利尿剂和醛固酮拮抗剂无反应的顽固性腹水患者骨骼肌体积的变化。

方法
本项回顾性研究纳入了42例接受托伐普坦治疗难治性腹水和/或肝性水肿的患者,并在开始服用托伐普坦之前和之后3个月接受了计算机断层扫描(CT)。每年骨骼肌指数的时间变化[ΔSMI(%)]计算如下:ΔSMI(%)=(最终CT扫描时的SMI - 初始CT扫描时的SMI)/初始CT扫描时的SMI×100 /年CT扫描。

结果
符合条件的患者为23名男性和19名女性,中位年龄为71岁。中位随访时间为22.7个月。应答者组的ΔSMI(%)显着高于无应答者组。多变量分析显示对托伐普坦的反应是与肌肉质量增加相关的独立且重要的因素[比值比(OR)20.364; 95%CI 2.327-178.97; P=0.006]。应答组中托伐普坦的总生存率显着高于无应答者组。多变量分析显示,对托伐普坦治疗的反应是预后良好的重要因素(OR 3.884; 95%CI 1.264-11.931; P = 0.018)。呋塞米剂量与ΔSMI(%)之间存在显着的负相关(P = 0.014)。

结论
用托伐普坦治疗难治性腹水可减轻肌肉减少症的进展并改善失代偿期肝硬化患者的预后。

原始出处:

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    2019-11-10 许安
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    2019-09-19 guging

    谢谢!最新的信息读起来就是收获大

    0

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