Heart:稳定型心绞痛患者应使用心脏CT还是运动负荷试验?

2016-01-17 QQduhp 译 MedSci原创

目的该研究的目的是评估稳定性心绞痛患者进行心脏CT和运动负荷试验(EST)对患者健康相关性生活质量的改善对比。 方法研究人员在北爱尔兰进行随机对照试验,并采用成本效益分析方法评估。稳定性心绞痛患者随机接受心脏CT检查或EST检查。关注的主要结果是患者每一质量调整生命年(QALY)的医疗花费情况。 结果一共有500名患者参与实验,研究人员随机分配参与者接受心脏CT检查或EST检查,两组人数相等。结果

目的:该研究的目的是评估稳定型心绞痛患者进行心脏CT和运动负荷试验(EST)对患者健康相关性生活质量的改善对比。 

方法:研究人员在北爱尔兰进行随机对照试验,并采用成本效益分析方法评估。稳定型心绞痛患者随机接受心脏CT检查或EST检查。关注的主要结果是患者每一质量调整生命年(QALY)的医疗花费情况。 

结果:一共有500名患者参与实验,研究人员随机分配参与者接受心脏CT检查或EST检查,两组人数相等。结果显示,在美国,相比EST检查,进行心脏CT检查更为民众所接受,因为它既廉价 (总花费减少£50.45;95%CI:−£672.26-£571.36)又有效(增加 QALY时间为0.02年;95%CI:−0.02-0.05)。每增加1年的QALY民众至少需付£20 000,则他们更愿意选择心脏CT(83%)。分析显示,对于患冠状动脉疾病风险为<30%、30%-60%和>60%的民众而言,他们更愿意选择心脏CT进行检查,因为它省钱又有效。

结论:相比EST检查而言,具有患冠状动脉疾病风险的民众更愿意选择心脏CT进行检查,因为它安全有效又廉价。但是研究人员指出,他们还需在更多的医疗保健系统进行检查以观察这一结论是否就具有普遍性。  

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    2016-01-20 516009991

    学知识

    0

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    2016-01-19 zhaojie88
  5. [GetPortalCommentsPageByObjectIdResponse(id=1803346, encodeId=5da018033468b, content=<a href='/topic/show?id=8b44e528972' target=_blank style='color:#2F92EE;'>#稳定型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75289, encryptionId=8b44e528972, topicName=稳定型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18b32500069, createdName=108807375_62823127, createdTime=Sat Sep 17 13:14:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998468, encodeId=2ba61998468f0, content=<a href='/topic/show?id=b71851393ad' target=_blank style='color:#2F92EE;'>#心脏CT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51393, encryptionId=b71851393ad, topicName=心脏CT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Wed Jul 13 07:14:00 CST 2016, time=2016-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58476, encodeId=44e5584e6df, content=学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=af601296712, createdName=516009991, createdTime=Wed Jan 20 07:53:00 CST 2016, time=2016-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356048, encodeId=ac4113560487b, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562349, encodeId=2cd7156234922, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568886, encodeId=e73d1568886e6, content=<a href='/topic/show?id=7de4e529403' target=_blank style='color:#2F92EE;'>#稳定型心绞痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75294, encryptionId=7de4e529403, topicName=稳定型心绞痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615115475291, createdName=lizhou0209, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58241, encodeId=4baa5824161, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 18 19:27:00 CST 2016, time=2016-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58242, encodeId=0f8d58242bc, content=关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 18 19:27:00 CST 2016, time=2016-01-18, status=1, ipAttribution=)]
    2016-01-19 slcumt
  6. [GetPortalCommentsPageByObjectIdResponse(id=1803346, encodeId=5da018033468b, content=<a href='/topic/show?id=8b44e528972' target=_blank style='color:#2F92EE;'>#稳定型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75289, encryptionId=8b44e528972, topicName=稳定型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18b32500069, createdName=108807375_62823127, createdTime=Sat Sep 17 13:14:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998468, encodeId=2ba61998468f0, content=<a href='/topic/show?id=b71851393ad' target=_blank style='color:#2F92EE;'>#心脏CT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51393, encryptionId=b71851393ad, topicName=心脏CT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Wed Jul 13 07:14:00 CST 2016, time=2016-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58476, encodeId=44e5584e6df, content=学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=af601296712, createdName=516009991, createdTime=Wed Jan 20 07:53:00 CST 2016, time=2016-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356048, encodeId=ac4113560487b, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562349, encodeId=2cd7156234922, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568886, encodeId=e73d1568886e6, content=<a href='/topic/show?id=7de4e529403' target=_blank style='color:#2F92EE;'>#稳定型心绞痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75294, encryptionId=7de4e529403, topicName=稳定型心绞痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615115475291, createdName=lizhou0209, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58241, encodeId=4baa5824161, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 18 19:27:00 CST 2016, time=2016-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58242, encodeId=0f8d58242bc, content=关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 18 19:27:00 CST 2016, time=2016-01-18, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1803346, encodeId=5da018033468b, content=<a href='/topic/show?id=8b44e528972' target=_blank style='color:#2F92EE;'>#稳定型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75289, encryptionId=8b44e528972, topicName=稳定型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18b32500069, createdName=108807375_62823127, createdTime=Sat Sep 17 13:14:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998468, encodeId=2ba61998468f0, content=<a href='/topic/show?id=b71851393ad' target=_blank style='color:#2F92EE;'>#心脏CT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51393, encryptionId=b71851393ad, topicName=心脏CT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Wed Jul 13 07:14:00 CST 2016, time=2016-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58476, encodeId=44e5584e6df, content=学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=af601296712, createdName=516009991, createdTime=Wed Jan 20 07:53:00 CST 2016, time=2016-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356048, encodeId=ac4113560487b, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562349, encodeId=2cd7156234922, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568886, encodeId=e73d1568886e6, content=<a href='/topic/show?id=7de4e529403' target=_blank style='color:#2F92EE;'>#稳定型心绞痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75294, encryptionId=7de4e529403, topicName=稳定型心绞痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615115475291, createdName=lizhou0209, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58241, encodeId=4baa5824161, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 18 19:27:00 CST 2016, time=2016-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58242, encodeId=0f8d58242bc, content=关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 18 19:27:00 CST 2016, time=2016-01-18, status=1, ipAttribution=)]
    2016-01-18 xyfg98

    赞一个

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1803346, encodeId=5da018033468b, content=<a href='/topic/show?id=8b44e528972' target=_blank style='color:#2F92EE;'>#稳定型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75289, encryptionId=8b44e528972, topicName=稳定型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18b32500069, createdName=108807375_62823127, createdTime=Sat Sep 17 13:14:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998468, encodeId=2ba61998468f0, content=<a href='/topic/show?id=b71851393ad' target=_blank style='color:#2F92EE;'>#心脏CT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51393, encryptionId=b71851393ad, topicName=心脏CT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Wed Jul 13 07:14:00 CST 2016, time=2016-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58476, encodeId=44e5584e6df, content=学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=af601296712, createdName=516009991, createdTime=Wed Jan 20 07:53:00 CST 2016, time=2016-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356048, encodeId=ac4113560487b, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562349, encodeId=2cd7156234922, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568886, encodeId=e73d1568886e6, content=<a href='/topic/show?id=7de4e529403' target=_blank style='color:#2F92EE;'>#稳定型心绞痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75294, encryptionId=7de4e529403, topicName=稳定型心绞痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615115475291, createdName=lizhou0209, createdTime=Tue Jan 19 02:14:00 CST 2016, time=2016-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58241, encodeId=4baa5824161, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 18 19:27:00 CST 2016, time=2016-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=58242, encodeId=0f8d58242bc, content=关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 18 19:27:00 CST 2016, time=2016-01-18, status=1, ipAttribution=)]
    2016-01-18 xyfg98

    关注

    0

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82岁老年男性,他舌头的左外侧缘有如下图所示的深的痛性溃疡。溃疡出现的6个月前他因为心绞痛开始服用尼可地尔。出现口腔溃疡后患者停止服用尼可地尔,在停药后的1-5周患者溃疡和疼痛情况均得到有效改善。服用尼可地尔的人群中口腔溃疡发生率为0.4-5%。在使用尼可地尔治疗4周-36个月,溃疡可发生在任何治疗剂量情况下。关于尼可地尔导致溃疡的机制目前并不清楚。出现该类情况可以使用盐酸苄达明喷雾和口服止痛药。

Circulation:雷诺嗪能改善PCI后血运重建患者的心绞痛吗?

经皮冠状动脉介入治疗(PCI)的人群经常伴随心绞痛持续和反复。研究人员假设,雷诺嗪将有效地减少PCI后不完全血运重建(ICR)患者心绞痛和改善生活质量(QOL)。在RIVER-PCI试验中,2604例具有慢性心绞痛病史且PCI术后有ICR的患者吧随机1:1分配接受口服雷诺嗪 vs 安慰剂;QOL分析包括2389例随机参与者。研究人员收集了基线和1,6,和12月的心绞痛和QOL问卷调查。雷诺嗪患者比

治疗顽固性心绞痛的新思路——COSIRA研究结果正式发表

河北省人民医院 郭艺芳临床上,部分心绞痛患者经过最佳药物治疗后仍不能满意控制症状,且因种种原因不适于冠脉介入治疗,此时治疗难度会非常大。根据刚刚正式发表的2期临床试验结果,应用冠状窦支架有望显著缓解患者心绞痛症状并改善生活质量。相关阅读:NEJM:顽固性心绞痛患者的福音来了冠状窦支架是一种球囊膨胀式沙漏状特殊装置,置入冠状窦后可以增加局部血流阻力,进而增加缺血心肌的灌注压,缓解缺血相关症状。刚刚正