Resuscitation:抗血小板治疗能否改善院外心脏骤停后患者结局?

2017-12-06 吴星 环球医学

2017年12月,发表在《Resuscitation》的一项由美国科学家进行的研究,考察了抗血小板治疗与院外心脏骤停(OHCA)后患者结局之间的相关性。

2017年12月,发表在《Resuscitation》的一项由美国科学家进行的研究,考察了抗血小板治疗与院外心脏骤停(OHCA)后患者结局之间的相关性。

背景:OHCA期间血流中断导致微血管血栓形成、自主循环恢复后长时间灌注不足和重要器官受损。研究者检测了以下假设:心脏骤停前抗血小板和抗凝药物使用与心脏骤停后更少的器官功能障碍和更好的结局相关。

方法:研究者纳入一家教学医疗中心2005年1月至2014年10月治疗的OHCA患者。研究者将临床和人口统计学数据的前瞻性OHCA注册与结构化图表回顾相联合,以提取家庭抗血小板和抗凝药物。研究者建立非校正和校正回归模型,考察抗血小板和抗凝药物使用与心脏骤停后疾病严重程度、生存和功能良好恢复之间的相关性。

结果:1054例受试者中,心脏骤停前,295例(28%)患者被处方一种抗血小板药物,147例(14%)患者被处方一种抗凝药物。在校正模型中,抗血小板药物与较低的心脏骤停后疾病严重程度(校正OR 0.50 95% CI 0.33~0.77)、较大的出院生存几率(校正OR 1.74 95% CI 1.08~2.80)和较大的功能良好结局几率(校正OR 2.11 95% CI 1.17~3.79)相关。相比之下,通过任何药物的抗凝与疾病严重程度、出院生存或有利结局不相关。

结论:通过抗血小板药物预防骤停时和骤停后微血管血栓形成可以代表改善OHCA后结局的新的治疗目标。

原始出处:

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1738521, encodeId=60961e385212a, content=<a href='/topic/show?id=a9dd4e63c4' target=_blank style='color:#2F92EE;'>#CIT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4763, encryptionId=a9dd4e63c4, topicName=CIT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eabf34462441, createdName=12498877m109暂无昵称, createdTime=Wed Sep 05 12:13:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1689406, encodeId=6f9e16894067c, content=<a href='/topic/show?id=c48ae043c3' target=_blank style='color:#2F92EE;'>#ESUS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7043, encryptionId=c48ae043c3, topicName=ESUS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf8a28807345, createdName=12498cbcm09(暂无昵称), createdTime=Sun May 27 18:13:00 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1793288, encodeId=7baa1e932882d, content=<a href='/topic/show?id=c0e9153e218' target=_blank style='color:#2F92EE;'>#resuscitation#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15372, encryptionId=c0e9153e218, topicName=resuscitation)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/qXbLjJB4FSzhQS3C5qQFMJkqicRIJFL6zHFwwhv0I95nzA6xicevQcEica0gk4A58UkbMMriadAgTY2b7N7Yd0ZsQg/132, createdBy=910c2500152, createdName=HinsMax, createdTime=Sat Apr 28 06:13:00 CST 2018, time=2018-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305660, encodeId=1a2e1305660a0, content=<a href='/topic/show?id=1787983537c' target=_blank style='color:#2F92EE;'>#院外心脏骤停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98353, encryptionId=1787983537c, topicName=院外心脏骤停)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b96f328, createdName=wwzzly, createdTime=Fri Dec 08 05:13:00 CST 2017, time=2017-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479998, encodeId=adbe14e9998a4, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Fri Dec 08 05:13:00 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1738521, encodeId=60961e385212a, content=<a href='/topic/show?id=a9dd4e63c4' target=_blank style='color:#2F92EE;'>#CIT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4763, encryptionId=a9dd4e63c4, topicName=CIT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eabf34462441, createdName=12498877m109暂无昵称, createdTime=Wed Sep 05 12:13:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1689406, encodeId=6f9e16894067c, content=<a href='/topic/show?id=c48ae043c3' target=_blank style='color:#2F92EE;'>#ESUS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7043, encryptionId=c48ae043c3, topicName=ESUS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf8a28807345, createdName=12498cbcm09(暂无昵称), createdTime=Sun May 27 18:13:00 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1793288, encodeId=7baa1e932882d, content=<a href='/topic/show?id=c0e9153e218' target=_blank style='color:#2F92EE;'>#resuscitation#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15372, encryptionId=c0e9153e218, topicName=resuscitation)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/qXbLjJB4FSzhQS3C5qQFMJkqicRIJFL6zHFwwhv0I95nzA6xicevQcEica0gk4A58UkbMMriadAgTY2b7N7Yd0ZsQg/132, createdBy=910c2500152, createdName=HinsMax, createdTime=Sat Apr 28 06:13:00 CST 2018, time=2018-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305660, encodeId=1a2e1305660a0, content=<a href='/topic/show?id=1787983537c' target=_blank style='color:#2F92EE;'>#院外心脏骤停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98353, encryptionId=1787983537c, topicName=院外心脏骤停)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b96f328, createdName=wwzzly, createdTime=Fri Dec 08 05:13:00 CST 2017, time=2017-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479998, encodeId=adbe14e9998a4, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Fri Dec 08 05:13:00 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1738521, encodeId=60961e385212a, content=<a href='/topic/show?id=a9dd4e63c4' target=_blank style='color:#2F92EE;'>#CIT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4763, encryptionId=a9dd4e63c4, topicName=CIT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eabf34462441, createdName=12498877m109暂无昵称, createdTime=Wed Sep 05 12:13:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1689406, encodeId=6f9e16894067c, content=<a href='/topic/show?id=c48ae043c3' target=_blank style='color:#2F92EE;'>#ESUS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7043, encryptionId=c48ae043c3, topicName=ESUS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf8a28807345, createdName=12498cbcm09(暂无昵称), createdTime=Sun May 27 18:13:00 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1793288, encodeId=7baa1e932882d, content=<a href='/topic/show?id=c0e9153e218' target=_blank style='color:#2F92EE;'>#resuscitation#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15372, encryptionId=c0e9153e218, topicName=resuscitation)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/qXbLjJB4FSzhQS3C5qQFMJkqicRIJFL6zHFwwhv0I95nzA6xicevQcEica0gk4A58UkbMMriadAgTY2b7N7Yd0ZsQg/132, createdBy=910c2500152, createdName=HinsMax, createdTime=Sat Apr 28 06:13:00 CST 2018, time=2018-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305660, encodeId=1a2e1305660a0, content=<a href='/topic/show?id=1787983537c' target=_blank style='color:#2F92EE;'>#院外心脏骤停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98353, encryptionId=1787983537c, topicName=院外心脏骤停)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b96f328, createdName=wwzzly, createdTime=Fri Dec 08 05:13:00 CST 2017, time=2017-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479998, encodeId=adbe14e9998a4, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Fri Dec 08 05:13:00 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1738521, encodeId=60961e385212a, content=<a href='/topic/show?id=a9dd4e63c4' target=_blank style='color:#2F92EE;'>#CIT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4763, encryptionId=a9dd4e63c4, topicName=CIT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eabf34462441, createdName=12498877m109暂无昵称, createdTime=Wed Sep 05 12:13:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1689406, encodeId=6f9e16894067c, content=<a href='/topic/show?id=c48ae043c3' target=_blank style='color:#2F92EE;'>#ESUS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7043, encryptionId=c48ae043c3, topicName=ESUS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf8a28807345, createdName=12498cbcm09(暂无昵称), createdTime=Sun May 27 18:13:00 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1793288, encodeId=7baa1e932882d, content=<a href='/topic/show?id=c0e9153e218' target=_blank style='color:#2F92EE;'>#resuscitation#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15372, encryptionId=c0e9153e218, topicName=resuscitation)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/qXbLjJB4FSzhQS3C5qQFMJkqicRIJFL6zHFwwhv0I95nzA6xicevQcEica0gk4A58UkbMMriadAgTY2b7N7Yd0ZsQg/132, createdBy=910c2500152, createdName=HinsMax, createdTime=Sat Apr 28 06:13:00 CST 2018, time=2018-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305660, encodeId=1a2e1305660a0, content=<a href='/topic/show?id=1787983537c' target=_blank style='color:#2F92EE;'>#院外心脏骤停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98353, encryptionId=1787983537c, topicName=院外心脏骤停)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b96f328, createdName=wwzzly, createdTime=Fri Dec 08 05:13:00 CST 2017, time=2017-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479998, encodeId=adbe14e9998a4, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Fri Dec 08 05:13:00 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1738521, encodeId=60961e385212a, content=<a href='/topic/show?id=a9dd4e63c4' target=_blank style='color:#2F92EE;'>#CIT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4763, encryptionId=a9dd4e63c4, topicName=CIT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eabf34462441, createdName=12498877m109暂无昵称, createdTime=Wed Sep 05 12:13:00 CST 2018, time=2018-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1689406, encodeId=6f9e16894067c, content=<a href='/topic/show?id=c48ae043c3' target=_blank style='color:#2F92EE;'>#ESUS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7043, encryptionId=c48ae043c3, topicName=ESUS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf8a28807345, createdName=12498cbcm09(暂无昵称), createdTime=Sun May 27 18:13:00 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1793288, encodeId=7baa1e932882d, content=<a href='/topic/show?id=c0e9153e218' target=_blank style='color:#2F92EE;'>#resuscitation#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15372, encryptionId=c0e9153e218, topicName=resuscitation)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/qXbLjJB4FSzhQS3C5qQFMJkqicRIJFL6zHFwwhv0I95nzA6xicevQcEica0gk4A58UkbMMriadAgTY2b7N7Yd0ZsQg/132, createdBy=910c2500152, createdName=HinsMax, createdTime=Sat Apr 28 06:13:00 CST 2018, time=2018-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305660, encodeId=1a2e1305660a0, content=<a href='/topic/show?id=1787983537c' target=_blank style='color:#2F92EE;'>#院外心脏骤停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98353, encryptionId=1787983537c, topicName=院外心脏骤停)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b96f328, createdName=wwzzly, createdTime=Fri Dec 08 05:13:00 CST 2017, time=2017-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479998, encodeId=adbe14e9998a4, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Fri Dec 08 05:13:00 CST 2017, time=2017-12-08, status=1, ipAttribution=)]

相关资讯

CYP2C19基因型指导的抗血小板治疗可能是有益的

根据11月1日在JACC网站上发表的一项研究,在经皮冠状动脉介入治疗后(PCI),氯吡格雷与抗血小板替代疗法相比,失去CYP2C19功能等位基因的患者发生重大不良心血管事件(MACE)的风险增加。来自于盖恩斯维尔佛罗里达大学Larisa H. Cavallari博士和他的同事们研究了经PCI治疗后,CYP2C19基因表型抗血小板治疗的临床结果。作者比较了功能性等位基因氯吡格雷和替代疗法患者PCI术

重复 Stroke:既往APT治疗的AIS患者:低剂量vs标准剂量阿替普酶

卒中是致残率、致死率最高的疾病之一,也是中国首位常见的死亡原因。其中急性缺血性卒中最为常见,约占全部卒中类型的60%~80%。因此缺血性卒中的预防和治疗已经成为广泛关注的焦点。2017年7月,发表在《Stroke》的一项研究调查了既往抗血小板治疗(APT)的急性缺血性卒中患者使用低剂量vs标准剂量阿替普酶的相对影响。

N Engl J Med:卒中后卵圆孔未闭封堵术联合抗血小板治疗有何利弊?

2017年9月,发表在《N Engl J Med.》的一项多中心、随机化、开放标签试验调查了卒中后卵圆孔未闭封堵术或抗凝vs抗血小板治疗的疗效。

Hepatology:抗血小板治疗会降低慢性乙肝患者HCC风险吗?

2017年11月,发表在《Hepatology》上的一项回顾性分析,考察了抗血小板治疗是否会降低慢性乙型肝炎患者的肝细胞癌(HCC)风险。分析结果表明:抗血小板治疗会降低乙型肝炎病毒被有效抑制的慢性乙型肝炎患者HCC风险。但包含氯吡格雷的抗血小板治疗会增加出血风险。

Lancet:药物洗脱支架用于75岁以上老年冠心病患者效果优于裸金属支架

研究认为,对于接受经皮冠状动脉介入的75岁以上患者,药物洗脱支架联合短期双联抗血小板治疗相比裸金属支架联合短期双联抗血小板治疗,可降低患者全因死亡、心肌梗死、中风与缺血驱动的靶病变血运重建的发生率,同时药物洗脱支架联合短期双联抗血小板治疗可降低PCI后老年患者的出血风险

Stroke:既往抗血小板治疗与卒中后颅内出血引发的死亡相关?

2017年发表在《Stroke》的一项由加拿大科学家进行的研究,考察了既往使用抗血小板药物治疗(APT)与颅内出血(ICH)死亡风险的相关性。