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NEJM：氯沙坦与阿替洛尔治疗马凡综合征的效果一致

2014-12-02 MedSci MedSci原创译

马凡综合征氯沙坦阿替洛尔主动脉根部扩张主动脉夹层
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主动脉根部夹层是马凡综合征的首要致死原因。目前β受体阻滞剂是临床的标准治疗，但研究表明，氯沙坦减缓主动脉夹层扩张的效果优于β受体阻滞剂。为了比较氯沙坦和阿替洛尔治疗主动脉根部扩张的效果，美国Ronald V. Lacro等人用随机对照试验将患马凡综合征的儿童和青年分成氯沙坦治疗组和阿替洛尔治疗组，该项研究发表于今年11月的新英格兰医学杂志上。研究纳入了2007年1月至2011年2月，共21个临床中

主动脉根部夹层是马凡综合征的首要致死原因。目前β受体阻滞剂是临床的标准治疗，但研究表明，氯沙坦减缓主动脉夹层扩张的效果优于β受体阻滞剂。为了比较氯沙坦和阿替洛尔治疗主动脉根部扩张的效果，美国Ronald V. Lacro等人用随机对照试验将患马凡综合征的儿童和青年分成氯沙坦治疗组和阿替洛尔治疗组，该项研究发表于今年11月的新英格兰医学杂志上。研究纳入了2007年1月至2011年2月，共21个临床中心608名患者，他们年龄范围在6个月至25岁，主动脉根z指数大于3.0。主要研究结果显示，主动脉根部扩张率，即主动脉根部直径的最大变化值与体表面积相关。次要研究结果包括：主动脉根部绝对直径的变化率、主动脉反流的变化率、主动脉夹层出现的时间、主动脉根部手术或死亡、身体增长以及不良事件发生率。阿替洛尔组和氯沙坦组平均主动脉根部z指数的基准调整率没有明显差异。两条曲线都显著低于0，表明治疗后主动脉根部直径相对于体表面积显著下降。3年中，两组主动脉根部手术、主动脉夹层以及死亡率没有显著差异。通过对儿童和青年马凡综合征患者进行氯沙坦或阿替洛尔治疗为期3年的研究，研究者并没有发现两组的主动脉根部扩张率有明

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    2016-03-17 忠诚向上

    好好学习

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    2016-03-17 忠诚向上

    好好学习

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    2016-03-17 忠诚向上

    好好学习

    0

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    2016-03-17 忠诚向上

    好好学习

    0

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    2016-03-17 忠诚向上

    好好学习

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=70301, encodeId=1972e03011e, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70300, encodeId=a158e0300b3, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70299, encodeId=1783e0299f0, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70288, encodeId=8128e0288bf, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70298, encodeId=04b8e02985e, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70297, encodeId=136be029752, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70296, encodeId=4732e0296d2, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70295, encodeId=674ee0295ff, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70294, encodeId=2e44e0294cc, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70293, encodeId=85f0e029307, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=)]
    2016-03-17 忠诚向上

    好好学习

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=70301, encodeId=1972e03011e, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70300, encodeId=a158e0300b3, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70299, encodeId=1783e0299f0, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70288, encodeId=8128e0288bf, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70298, encodeId=04b8e02985e, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70297, encodeId=136be029752, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70296, encodeId=4732e0296d2, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70295, encodeId=674ee0295ff, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70294, encodeId=2e44e0294cc, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70293, encodeId=85f0e029307, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=)]
    2016-03-17 忠诚向上

    好好学习

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=70301, encodeId=1972e03011e, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70300, encodeId=a158e0300b3, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70299, encodeId=1783e0299f0, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70288, encodeId=8128e0288bf, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70298, encodeId=04b8e02985e, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70297, encodeId=136be029752, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70296, encodeId=4732e0296d2, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70295, encodeId=674ee0295ff, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70294, encodeId=2e44e0294cc, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70293, encodeId=85f0e029307, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=)]
    2016-03-17 忠诚向上

    好好学习

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=70301, encodeId=1972e03011e, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70300, encodeId=a158e0300b3, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70299, encodeId=1783e0299f0, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:27:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70288, encodeId=8128e0288bf, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70298, encodeId=04b8e02985e, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70297, encodeId=136be029752, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70296, encodeId=4732e0296d2, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70295, encodeId=674ee0295ff, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70294, encodeId=2e44e0294cc, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70293, encodeId=85f0e029307, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Mar 17 17:26:00 CST 2016, time=2016-03-17, status=1, ipAttribution=)]
    2016-03-17 忠诚向上

    好好学习

    0

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    2016-03-17 忠诚向上

    好好学习

    0

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