Int J Cardiol:β-肾上腺素能阻断对慢性心力衰竭患者体重变化的影响!

2018-03-23 xing.T MedSci原创

由此可见,与未接受或耐受β受体阻滞剂的患者相比,由于LVSD的CHF患者接受β受体阻滞剂治疗发生恶病质的可能性较小,并且体重增加和更好结局的可能性更大。

体重减轻在慢性心力衰竭(CHF)患者中很常见,并且与不良结局相关。交感神经系统的激活与体重减轻、消瘦和恶病质有关。然而,交感神经拮抗作用对CHF患者体重变化的影响尚不明确。

近日,心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员评估了由于左心室收缩功能障碍(LVSD)(LV射血分数(LVEF)<40)的未经选择的CHF患者体重变化、恶病质(体重减轻>6%)和显著体重增加(>5%),并研究了β-阻滞对体重变化的影响。

在招募的1480名患者中(中位NTproBNP:1651ng / L,中位LVEF:31%),86%的患者接受β受体阻滞剂治疗,11%从未接受β受体阻滞剂治疗,3%的患者在基线和1年之间停用β受体阻滞剂。没有服用或不耐受β受体阻滞剂的患者发生恶病质的可能性要高于服用β受体阻滞剂的患者(23% vs. 10%,P<0.001),而体重增加的可能性更小(22% vs. 24%,P<0.001)。中位随访1876天(IQR:993-3052天)期间,894例(60%)患者死亡。基线时较大的体重指数(BMI)、体重增加和β受体阻滞剂治疗与较好的结局相关。同时具备3个特征:β受体阻滞剂治疗、基线BMI≥25和显著体重增加的患者具有最佳结果(5年死亡率为22%)。

由此可见,与未接受或耐受β受体阻滞剂的患者相比,由于LVSD的CHF患者接受β受体阻滞剂治疗发生恶病质的可能性较小,并且体重增加和更好结局的可能性更大。

原始出处:

Shirley Sze ,et al. Effect of beta-adrenergic blockade on weight changes in patients with chronic heart failure.International Journal of Cardiology.2018. https://doi.org/10.1016/j.ijcard.2018.03.089

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likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c09d1605573, createdName=aa6081, createdTime=Fri Mar 23 16:00:00 CST 2018, time=2018-03-23, status=1, ipAttribution=)]
  6. 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objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Sat Mar 24 11:00:59 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299032, encodeId=4c4e29903240, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Mar 23 21:25:46 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=298976, encodeId=84ce2989e6d3, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, 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  7. 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objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Sat Mar 24 11:00:59 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299032, encodeId=4c4e29903240, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Mar 23 21:25:46 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=298976, encodeId=84ce2989e6d3, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c09d1605573, createdName=aa6081, createdTime=Fri Mar 23 16:00:00 CST 2018, time=2018-03-23, status=1, ipAttribution=)]
    2018-03-24 惠映实验室

    学习了.谢谢分享.

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1895121, encodeId=38d8189512101, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Wed Nov 07 10:22:00 CST 2018, time=2018-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781895, encodeId=3d7a1e81895ba, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sun Jan 06 18:22:00 CST 2019, time=2019-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710124, encodeId=b5c51e101241c, content=<a href='/topic/show?id=7ac59e67604' target=_blank style='color:#2F92EE;'>#阻断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97676, encryptionId=7ac59e67604, topicName=阻断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5ca31824852, createdName=41514497@qq.com, createdTime=Sat Sep 08 13:22:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079416, encodeId=fc9620e9416ca, content=<a href='/topic/show?id=7f7d266897b' target=_blank style='color:#2F92EE;'>#体重变化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26689, 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channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82441, encryptionId=b67d8244123, topicName=肾上腺素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sun Mar 25 02:22:00 CST 2018, time=2018-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299374, encodeId=cf252993e432, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Mar 24 23:53:12 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299252, encodeId=702329925259, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Sat Mar 24 11:00:59 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299032, encodeId=4c4e29903240, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Mar 23 21:25:46 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=298976, encodeId=84ce2989e6d3, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c09d1605573, createdName=aa6081, createdTime=Fri Mar 23 16:00:00 CST 2018, time=2018-03-23, status=1, ipAttribution=)]
    2018-03-24 yfjms

    学习

    0

  9. 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channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82441, encryptionId=b67d8244123, topicName=肾上腺素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sun Mar 25 02:22:00 CST 2018, time=2018-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299374, encodeId=cf252993e432, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Mar 24 23:53:12 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299252, encodeId=702329925259, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Sat Mar 24 11:00:59 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299032, encodeId=4c4e29903240, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Mar 23 21:25:46 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=298976, encodeId=84ce2989e6d3, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c09d1605573, createdName=aa6081, createdTime=Fri Mar 23 16:00:00 CST 2018, time=2018-03-23, status=1, ipAttribution=)]
    2018-03-23 虈亣靌

    学习了很有用不错

    0

  10. 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channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82441, encryptionId=b67d8244123, topicName=肾上腺素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Sun Mar 25 02:22:00 CST 2018, time=2018-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299374, encodeId=cf252993e432, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Mar 24 23:53:12 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299252, encodeId=702329925259, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Sat Mar 24 11:00:59 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299032, encodeId=4c4e29903240, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Mar 23 21:25:46 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=298976, encodeId=84ce2989e6d3, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c09d1605573, createdName=aa6081, createdTime=Fri Mar 23 16:00:00 CST 2018, time=2018-03-23, status=1, ipAttribution=)]
    2018-03-23 aa6081

    学习了.谢谢分享.

    0