盘点:2018年8月25日Lancet研究精选

2018-08-24 zhangfan MedSci原创

2018年8月25日Lancet研究精选



【1】瑞芬太尼自控镇痛用于产前阵痛


据统计在需接受分娩镇痛的人群中,约1/3采用哌替啶硬膜外注射,在缓解疼痛的同时增加了阴道分娩助产机械的使用风险。瑞芬太尼病人自控镇痛(PCA)是一种哌替啶替代方法,目前尚未得到广泛使用。近日研究人员对二者镇痛效果的差异进行了比较。16岁以上,孕37周以上,单胎头位且需要阿片类镇痛的产妇参与研究,随机接受静脉瑞芬太尼PCA(40μg 每次,最小间隔给药时间2min)或肌内哌替啶(每4小时100mg,24小时给药不超过400mg)。研究的主要终点为分娩镇痛后仍需接受硬膜外镇痛的比例。201名产妇接受PCA,199人接受哌替啶。瑞芬太尼PCA组中19%的产妇接受硬膜外镇痛(39/201),而哌替啶组为41%(81/199),比值比为0.48。

【2】全球蛇咬伤事件风险评估


蛇咬伤是一个经常被忽视的死亡和致残原因,近日研究人员就全球范围内蛇咬伤事件风险进行了评估。

研究总计统计了278种蛇类,总计68.5亿人群生活在蛇咬伤易发地区,其中1.46亿人群缺少相应的医疗保障,65.25%的医疗保健机会和质量指数(HAQ指数)较低地区人群无法接受有效的蛇咬伤后医疗护理,特别是无法及时注射抗蛇毒血清。依据WHO的评估,278种蛇类中有119种(43%)有抗蛇毒血清,7.5亿 (10.95%)生活在蛇咬伤高发地区的居民其生活地区距离人口稠密地区的车程在1小时以上。多撒哈拉以南国家、印度尼西亚和东南亚其他地区均为蛇咬伤高风险地区,大约9266万人生活在上述地区。

【3】索马鲁肽减肥效果评估


肥胖是一个重要的公共卫生问题。近日研究人员评估了胰高血糖素样肽-1(GLP-1)类似物索马鲁肽的减肥效果。957名患者参与研究,基线年龄47岁,平均体重111.5kg,BMI=39.3。93%的患者完成52周研究。安慰剂组平均体重减少2.3%,而不同剂量(0.05、0.1、0.2、0.3以及0.4mg)索马鲁肽组患者体重分别减少6%、8.6%、11.6%、11.2%以及13.8%。索马鲁肽的减肥效果显著优于利拉鲁肽(体重减少11.2-13.8% vs 7.8%)。接受索马鲁肽治疗人群减重10%以上的比例为37-65%,而安慰剂组仅为10%。最常见的不良事件为与剂量有关的肠道症状,主要是恶心。

【4】Risankizumab治疗中重度斑块状银屑病效果显著


近日研究人员评估了人源性IgG1单克隆抗体risankizumab对中重度慢性斑块状银屑病的疗效和安全性。

研究分为2个阶段,总计997例患者参与,研究的主要终点为银屑病面积严重度指数改善90%以上患者比例。第1阶段,risankizumab组75.3%的患者实现主要终点,乌司奴单抗组为42%,而安慰剂组仅4.9% 。第2阶段中, risankizumab组74.8%的患者实现主要终点,乌司奴单抗组为47.5%,而安慰剂组仅为2.0%。risankizumab组2个阶段医生病情评估0-1分的患者比例分别为87.8%和83.7%,乌司奴单抗组为63.0%和61.6%,而安慰剂组仅为7.8%和5.1%。组间不良事件率差异不显著。

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    2019-04-26 howi
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    2018-08-29 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2018-08-27 huangshang9812

    哈哈哈,学习了

    0

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    2018-08-24 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

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【1】封面文章--不推荐分泌性中耳炎患儿接受口服类固醇治疗DOI:https://doi.org/10.1016/S0140-6736(18)31490-9伴有积液,持续性听力损伤中耳炎患儿通常需要外科治疗。近日研究人员考察了短期口服类固醇对持续性中耳炎并伴有渗出和听力损失患儿的疗效。389名2-8岁的中耳炎患儿参与研究,治疗5周后 ,类固醇组73名(40%)患儿以及安慰剂组59名患儿(33%)听