JAMA:促红素和成分输血并不改善急重颅脑损伤患者的预后

2014-07-04 MedSci MedSci原创

据7月2日发表在《美国医学会杂志》(JAMA)发表一项随机对照研究,比较严重颅脑损伤时,促红素(EPO)与安慰剂对比,对患者脑损伤恢复的影响。 这项随机对照试验,共招募200人(EPO组102人,安慰剂组98人),均属于闭合性颅损伤,损伤6小时内,住入神经病学急诊ICU的患者。这项研究从2006年5月份开始,持续到2012年8月结束。采用析因设计策略,比较EPO对能否改善患者6个月月后Glasg

据7月2日发表在《美国医学会杂志》(JAMA)发表一项随机对照研究,比较严重颅脑损伤时,促红素(EPO)与安慰剂对比,对患者脑损伤恢复的影响。

这项随机对照试验,共招募200人(EPO组102人,安慰剂组98人),均属于闭合性颅损伤,损伤6小时内,住入神经病学急诊ICU的患者。这项研究从2006年5月份开始,持续到2012年8月结束。采用析因设计策略,比较EPO对能否改善患者6个月月后Glasgow Outcome Scale(GOS)评分。其中,患者血红蛋白域值在10 g/dL有101例,在7 g/dL有99例。EPO(500 IU/kg per dose)和安慰剂起始给药3天,然后每周一次,给药超过2周以上(74例),24和48小时后停止的126例。低于输血域值采用红细胞成分输血。

结果显示,无论是EPO,还是输血,都不能改善患者6个月的神经功能评分。而且,如果输血的血红蛋白域值为10 g/dL时,可能还会增加不良事件的发生。

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原始出处:

Claudia S. Robertson,et al.Effect of Erythropoietin and Transfusion Threshold on Neurological Recovery After Traumatic Brain InjuryA Randomized Clinical Trial.JAMA. 2014;312(1):36-47.

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    2014-07-06 windight
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