JASN:高透析率β阻滞剂或增透析者死亡风险

2014-11-05 高晓方 译 医学论坛网

β受体阻滞剂一般用于透析患者减少心脏猝死风险。近期加拿大学者进行了相关研究。结果表明,在长期血液透析患者中,与低透析率β受体阻滞剂相比,高透析率β受体阻滞剂可能导致死亡风险显著升高。论文10月30日在线发表于《美国肾脏病学会杂志》(J Am Soc Nephrol)。 此项基于人群的回顾性队列研究共纳入6588例长期接受透析治疗的受试者,其中β阻滞剂高、低透析率组各纳入3294例患者,该

β受体阻滞剂一般用于透析患者减少心脏猝死风险。近期加拿大学者进行了相关研究。结果表明,在长期血液透析患者中,与低透析率β受体阻滞剂相比,高透析率β受体阻滞剂可能导致死亡风险显著升高。论文10月30日在线发表于《美国肾脏病学会杂志》(J Am Soc Nephrol)。

此项基于人群的回顾性队列研究共纳入6588例长期接受透析治疗的受试者,其中β阻滞剂高、低透析率组各纳入3294例患者,该研究无对照组(未接受β受体阻滞剂治疗的患者)。

高透析率药物包括阿替洛尔、醋丁洛尔和美托洛尔,低透析率药物包括比索洛尔和普萘洛尔。评估β阻滞剂透析率对患者转归的影响。结果显示,与β阻滞剂低透析率组相比,高透析率组患者随后180天内的死亡风险显著升高(相对危险度 1.4;P=0.006)。

研究者表示,β阻滞剂药代动力学复杂,药物透析率则由多种因素之间的复杂相互作用而决定,因此需审慎解读相关结果。比索洛尔具有较高的β-1选择性,并有可能促成了其在透析人群中的安全性优势。未来需对不同β阻滞剂的差异进行更为深入的研究。

原始出处:

Weir MA1, Dixon SN2, Fleet JL3, Roberts MA4, Hackam DG5, Oliver MJ6, Suri RS7, Quinn RR8, Ozair S3, Beyea MM3, Kitchlu A3, Garg AX9.β-Blocker Dialyzability and Mortality in Older Patients Receiving Hemodialysis.J Am Soc Nephrol. 2014 Oct 30. pii: ASN.2014040324. [Epub ahead of print]

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    2015-09-15 chenhongpeng
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    2015-02-23 zhyy88
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