盘点:2020年8月8日Lancet研究精选

2020-08-09 MedSci原创 MedSci原创

2020年8月8日Lancet研究精选

【1】新冠肺炎疫情对英国急性冠状动脉综合征患者入院治疗率的影响
 
 
统计发现COVID-19大流行期间,急性冠状动脉综合征急诊患者人数大幅下降,接受心脏手术人数减少。 近日研究人员就英国新冠疫情期间不同类型急性冠状动脉综合征患者入院情况变化进行了考察。
 
研究人员分析了从2019年1月1日到2020年5月24日在英国急性冠状动脉综合征患者入院数据。入院分类为ST段抬高型心肌梗死(STEMI),非STEMI(NSTEMI),不明类型心肌梗死,或其他急性冠状动脉综合征(包括不稳定型心绞痛)。 患者入院期间进行的血管重建手术,包括无需经皮冠状动脉介入治疗(PCI)、PCI治疗和冠状动脉旁路移植术。急性冠状动脉综合征的住院患者人数从2020年2月中旬开始下降,从2019年的每周3017人下降到2020年3月底的每周1813人,减少40%。 这一下降趋势在2020年4月和5月得到了部分扭转,到2020年5月的最后一周,有2522人入院,较2019年减少了16%。 在入院人数下降期间,包括STEMI和NSTEMI在内的所有类型急性冠状动脉综合征的入院人数都有所减少,但NSTEMI的相对和绝对变化较为显著,2019年NSTEMI患者为1267例,2020年3月底为733例,下降42%。同时,STEMI患者接受PCI次数减少:2019年每周需进行438次PCI手术,而2020年3月底为346次;减少21%,NSTEMI患者PCI次数也大幅减少:2019年每周需进行383次PCI手术,2020年3月底为240次;减少37%。急性冠状动脉综合征患者的平均住院时间从2019年的4天下降到2020年3月底的3天。
 
【2】成人2mm以下腕舟骨骨折治疗--石膏固定 vs 手术固定
 
 
90%的腕关节骨折患者为腕舟骨骨折,其中年轻男性占多数,近日研究人员开展 SWIFFT研究,比较了腕舟骨骨折移位2 mm或以下成人患者接受手术固定或石膏固定的临床效果差异。
 
439名16岁以上,X线确诊2 mm或以下腕舟骨骨折移患者参与,随机接受早期手术固定(手术组,n=219)或肘下石膏固定(n=220),石膏固定组如果骨折被证实不愈合,则立即进行手术固定。研究的主要结果是随机化后52周的患者评分手腕 (PRWE)评分。52周时,手术组(调整后平均PRWE得分11.9)和固定石膏组(14.0分,调整平均差-2.1,p=0o27)在的平均PRWE评分没有显著差异。与石膏固定组相比(220名参与者中有3人[1%]),手术组参与者(219名参与者中的31人[14%])的严重并发症风险较高,但与固定石膏组(40名[18%])相比,手术组(5名[2%])发生石膏相关并发症的风险较低。组间需医疗干预的并发症的人数相似(手术组4例[2%],石膏固定组5例[2%])。
 
【3】HIV阳性的多药耐药性结核病患者药物治疗对死亡率的影响
 
 
HIV感染可导致多药耐药性结核病患者的死亡率增加,近日研究人员考察了抗逆转录病毒疗法(ART)联合抗结核药物对多药耐药性结核病的HIV阳性患者死亡率的影响。
 
本次研究为系统综述及荟萃分析,考察1993-2016年间确诊的多药耐药性结核病患者治疗数据,初步分析中比较了HIV阳性和HIV阴性患者在多重耐药结核病治疗期间的死亡率差异。研究包含11920名多药耐药结核病患者数据,其中2997例(25%)为HIV阳性且接受ART治疗,抗886例(7%)为HIV阳性但未接受ART治疗,1749例(15%)为广泛耐药性结核病患者。 以HIV阴性患者为参考,所有HIV感染患者的死亡风险比为2.4,接受ART后患者死亡风险为1.8,未接受ART患者死亡风险为4.2。 在HIV阳性患者中,使用至少一种WHO A类抗结核药物和特定使用莫西沙星、左氧氟沙星、贝达奎林或利奈唑类药物均可显著降低死亡风险。

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    2021-02-16 howi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1830777, encodeId=41ec1830e77ac, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Feb 16 20:38:54 CST 2021, time=2021-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813674, encodeId=53aa8136e452, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 07:50:22 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=808328, encodeId=5ba1808328bd, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200804/62f3c5bb78aa4f1bac3aef7bcd9c1c0d/029c3f00f77d40db887fd7feb647c9ef.jpg, createdBy=c8e65408461, createdName=月瘦如眉, createdTime=Thu Aug 13 07:04:33 CST 2020, time=2020-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=807137, encodeId=3b3580e1373b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68522530515, createdName=124fe80fm82暂无昵称, createdTime=Sun Aug 09 20:08:02 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033921, encodeId=c1fa103392136, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sun Aug 09 11:38:54 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=807074, encodeId=0d9080e07410, content=谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200809/8efc7089f83541b58578e05f1e9ed30c/867bb46e36f24fbf97010ce808c86275.jpg, createdBy=1db55409746, createdName=ms9000000457302034, createdTime=Sun Aug 09 09:59:45 CST 2020, time=2020-08-09, status=1, ipAttribution=)]
    2020-08-27 14818eb4m67暂无昵称

    学习了

    0

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    2020-08-13 月瘦如眉

    谢谢分享!

    0

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    2020-08-09 124fe80fm82暂无昵称

    学习了

    0

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    2020-08-09 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1830777, encodeId=41ec1830e77ac, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Feb 16 20:38:54 CST 2021, time=2021-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813674, encodeId=53aa8136e452, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 07:50:22 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=808328, encodeId=5ba1808328bd, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200804/62f3c5bb78aa4f1bac3aef7bcd9c1c0d/029c3f00f77d40db887fd7feb647c9ef.jpg, createdBy=c8e65408461, createdName=月瘦如眉, createdTime=Thu Aug 13 07:04:33 CST 2020, time=2020-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=807137, encodeId=3b3580e1373b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68522530515, createdName=124fe80fm82暂无昵称, createdTime=Sun Aug 09 20:08:02 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033921, encodeId=c1fa103392136, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sun Aug 09 11:38:54 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=807074, encodeId=0d9080e07410, content=谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200809/8efc7089f83541b58578e05f1e9ed30c/867bb46e36f24fbf97010ce808c86275.jpg, createdBy=1db55409746, createdName=ms9000000457302034, createdTime=Sun Aug 09 09:59:45 CST 2020, time=2020-08-09, status=1, ipAttribution=)]
    2020-08-09 ms9000000457302034

    谢谢!

    0

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