JACC:当心力衰竭遇上肺炎,患者还剩“几线生机”?

2021-04-26 Nebula MedSci原创

当心力衰竭遇上肺炎,患者还剩“几线生机”?

心力衰竭患者的心功能不全,任何加重氧耗的事情都可能会加重他们病情。肺炎不仅仅会增加患者的氧耗量,还会影响患者的氧供量。当心力衰竭遇上肺炎,患者还剩“几线生机”?

对于射血分数降低的心力衰竭(HFrEF)和射血分数保留的心力衰竭(HFpEF)患者,尚未有相关研究在他们中比较肺炎的发生率和后续临床结局。

本研究旨在在PARADIGM-HF试验和PARAGON-HF试验受试患者中评估肺炎的发生率和肺炎对患者预后的影响。

研究人员分析了两个临床试验中调查人报告的肺炎和肺炎发生前后HF住院、血管死亡和全因死亡的发生率。

在PARADIGM-HF试验中,有528位(6.3%)患者在随机分组后罹患了肺炎,发病率为29(95% CI 27-32)/1000人·年。在PARAGON-HF试验中,有510位(10.6%)患者罹患了肺炎,发病率为39(36-42)/1000人·年

心衰患者肺炎前后的累积全因死亡率

发生肺炎后,两个试验的受试患者的后续结局风险均升高。在PARADIGM-HF试验中,与发生肺炎前相比,发生肺炎后的全因死亡风险的校正风险比[HR]为4.34(95% CI 3.73-5.05);在PARAGON-HF试验中相应的校正HR为3.76(3.09-4.58)。

心衰患者肺炎后各临床预后的相对风险

综上所述,在心力衰竭患者中,肺炎的发生率升高,特别是对于HFpEF患者,约是预计发生率的3倍!此外,肺炎的发生与心力衰竭患者的死亡率增加了4倍有关

原始出处:

Shen Li,Jhund Pardeep S,Anand Inder S et al. Incidence and Outcomes of Pneumonia in Patients With Heart Failure.[J] .J Am Coll Cardiol, 2021, 77: 1961-1973. https://doi.org/10.1016/j.jacc.2021.03.001

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    2021-08-09 hbwxf
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    2021-05-02 Doctoryangbai

    非常有价值

    0

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    2021-04-27 ms4000001291496338

    学习

    0

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    2021-04-26 DRMORTON

    哦哦哦哦哦

    0

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