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World J Surg：闭合性创伤性脑损伤后，β受体阻滞剂对生存率的影响

2015-08-17 phylis 译 MedSci原创

创伤性脑损伤后(TBI)β受体阻滞剂
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背景：许多北美研究显示，创伤性脑损伤后(TBI)，应用β阻滞剂能提高患者生存率。这篇研究的主要目的就是评估瑞典的一组严重的闭合性TBI患者，应用β阻滞剂对其死亡率的影响。方法：收集了从2007年1月到2011年12月间，一个城市学院创伤中心中，严重的TBI患者的登记记录。严重的闭合性TBI定义为，AIS分数≥3的颅内损伤，并且排除颅外损伤。应用多变量logictic回归分析应用β阻滞剂对死亡率的影

背景：许多北美研究显示，创伤性脑损伤后(TBI)，应用β阻滞剂能提高患者生存率。这篇研究的主要目的就是评估瑞典的一组严重的闭合性TBI患者，应用β阻滞剂对其死亡率的影响。

方法：收集了从2007年1月到2011年12月间，一个城市学院创伤中心中，严重的TBI患者的登记记录。严重的闭合性TBI定义为，AIS分数≥3的颅内损伤，并且排除颅外损伤。应用多变量logictic回归分析应用β阻滞剂对死亡率的影响。另外，有一亚组分析患者入院应用β阻滞剂和不应用β阻滞剂对患者死亡率的影响，以及不同类型的β阻滞剂对患者整体预后的影响。

结果：有874名病人满足研究标准。其中，33%（n=287）的病人在住院期间，应用β阻滞剂。用药病人年纪较大，损伤较严重，根据入院时患者GCS，ISS和患者AIS分数判断患者的损伤的严重程度。其中，年龄：62 ± 16岁vs. 49 ± 21 岁， GCS ≤8: 32 % vs. 28 %； ISS ≥16: 71 % vs. 59 %; head AIS ≥4: 60 % vs. 45 %。住院期间，未用β阻滞剂组的粗死亡率较用β阻滞剂组高（17 % vs. 11 %）。校正显著混杂因素后，未用β阻滞剂组住院期间死亡率是用β阻滞剂组的5倍(AOR 5.0, CI 95 % 2.7–8.5)。不同类型的β阻滞剂对患者生存率的影响没有差异。亚组分析显示：那些入院前未应用β阻滞剂的病人比用β阻滞剂的病人有更高的死亡风险(AOR 3.0 CI 95 % 1.2–7.1)。

结论：严重闭合性创伤性脑损伤后，应用β阻滞剂能显著改善患者的生存率。我们也注意到，入院前应用β阻滞剂的病人，比入院前未用β阻滞剂的病人死亡率降低。还需要进一步的研究证实。

原文出处：

Mohseni S, Talving P, Thelin EP, Wallin G, Ljungqvist O, Riddez L.The Effect of β-blockade on Survival After Isolated Severe Traumatic Brain Injury.World J Surg. 2015 Aug;39(8):2076-83. 


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    2016-03-13 tulenzi

    #受体阻滞剂#

    0

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    2016-08-01 zhyy88

    #阻滞剂#

    0

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    2016-05-01 amyloid

    #创伤性#

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    2015-08-19 guoyibin

    #生存率#

    0

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    2015-08-19 muzishouyi

    #β受体阻滞剂#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1995118, encodeId=993a199511834, content=<a href='/topic/show?id=347538040cf' target=_blank style='color:#2F92EE;'>#受体阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38040, encryptionId=347538040cf, topicName=受体阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Sun Mar 13 12:17:00 CST 2016, time=2016-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2085714, encodeId=6d782085e147f, content=<a href='/topic/show?id=723a9e69383' target=_blank style='color:#2F92EE;'>#阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97693, encryptionId=723a9e69383, topicName=阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=40be178, createdName=zhyy88, createdTime=Mon Aug 01 15:17:00 CST 2016, time=2016-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025421, encodeId=ddc5202542199, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sun May 01 22:17:00 CST 2016, time=2016-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256515, encodeId=746b12565151c, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Wed Aug 19 08:17:00 CST 2015, time=2015-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1274930, encodeId=405912e49302a, content=<a href='/topic/show?id=338c19228b0' target=_blank style='color:#2F92EE;'>#β受体阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19228, encryptionId=338c19228b0, topicName=β受体阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=685a124, createdName=muzishouyi, createdTime=Wed Aug 19 08:17:00 CST 2015, time=2015-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335081, encodeId=9a741335081cd, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Wed Aug 19 08:17:00 CST 2015, time=2015-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1396937, encodeId=e306139693e80, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Wed Aug 19 08:17:00 CST 2015, time=2015-08-19, status=1, ipAttribution=)]
    2015-08-19 ms920641618706883

    #创伤#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1995118, encodeId=993a199511834, content=<a href='/topic/show?id=347538040cf' target=_blank style='color:#2F92EE;'>#受体阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38040, encryptionId=347538040cf, topicName=受体阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Sun Mar 13 12:17:00 CST 2016, time=2016-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2085714, encodeId=6d782085e147f, content=<a href='/topic/show?id=723a9e69383' target=_blank style='color:#2F92EE;'>#阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97693, encryptionId=723a9e69383, topicName=阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=40be178, createdName=zhyy88, createdTime=Mon Aug 01 15:17:00 CST 2016, time=2016-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025421, encodeId=ddc5202542199, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sun May 01 22:17:00 CST 2016, time=2016-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256515, encodeId=746b12565151c, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Wed Aug 19 08:17:00 CST 2015, time=2015-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1274930, encodeId=405912e49302a, content=<a href='/topic/show?id=338c19228b0' target=_blank style='color:#2F92EE;'>#β受体阻滞剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19228, encryptionId=338c19228b0, topicName=β受体阻滞剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=685a124, createdName=muzishouyi, createdTime=Wed Aug 19 08:17:00 CST 2015, time=2015-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335081, encodeId=9a741335081cd, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Wed Aug 19 08:17:00 CST 2015, time=2015-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1396937, encodeId=e306139693e80, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Wed Aug 19 08:17:00 CST 2015, time=2015-08-19, status=1, ipAttribution=)]
    2015-08-19 智者为医08

    #损伤#

    0