Semin Arthritis Rheu:有风湿热病史的儿童对青霉素预防用药的长期依从性差

2018-10-27 xiangting MedSci原创

风湿热患者对SPP的依从性很差。这使得这种长期预防模式没有效果。

反复发作的急性风湿热可能导致风湿性心脏病进展或恶化。已发现二级青霉素预防用药(SPP)可显著降低风湿性心脏病的发病率。这项研究旨在使用跨越10年的实际数据评估儿童风湿热患者口服和肌内SPP的依从性。

研究人群包括由以色列一家拥有210万名成员的健康维护组织担保的<18岁患者,这些患者于1996年1月1日至2015年5月期间被诊断为急性风湿热,并通过处方购买了至少一个月剂量的口服或肌注青霉素。计算SPP涵盖的平均天数比例。停药的回顾性随访终点是离开健康维护组织、死亡,年龄满18岁或随访结束。

该队列包括842名儿童:734名口服青霉素治疗,108名肌注青霉素。诊断时两组的平均(SD)年龄分别为8.6(3.7)年和10.9(3.2)年,SPP涵盖天数比例的中位数(四分位间距)为8%(2%-33%)和10%(3%-28%)。总体而言,所涵盖的天数从治疗第1年的103天指数下降至第10年的20天。

风湿热患者对SPP的依从性很差。这使得这种长期预防模式没有效果。尽管先前已证明IM途径更有效,但口服途径的使用更为广泛。

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    2018-10-29 fyxzlh
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    2018-10-29 zhaojie88
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    2018-10-29 sunyl09

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