Crit Care:感染性休克患者血液灌流多粘菌素B潜在的生存益处!

2017-06-07 xing.T MedSci原创

该研究结果表明采用PMX-HP治疗可以降低感染性休克患者的全因住院死亡率和缩短入住ICU的时间。

近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,该研究的目的是探讨血液灌流多粘菌素B(PMX-HP)是否可以改善感染性休克患者的生存。

研究人员在3年内接受治疗的患者进行了一项回顾性多中心研究。研究人员对日本感染性弥散性血管内凝血(JSEPTIC DIC)的研究数据库进行了倾向评分分析。这项研究纳入了1723名16岁以上的感染性休克患者的数据。此外,研究人员将患者分为接受PMX-HP治疗和无PMX HP治疗组。该研究的主要终点为全因住院死亡率;该研究的次要终点包括ICU(重症监护病房)死亡率、在第一个28 天内不入住ICU的天数(ICUFDs)。

在符合标准的1723例患者中,522名患者接受了PMX-HP治疗。倾向评分匹配了262对配对参与者(即PMX-HP治疗组和无PMX HP治疗组各有262例受试者)。研究人员发现PMX-HP治疗组全因住院死亡的比例较无PMX HP治疗组显著降低(32.8% vs. 41.2%;比值比(OR)为0.681;95%可信区间(CI)为0.470-0.987;P=0.042)。在第一个28 天内ICUFD在PMX-HP组要明显高于无PMX HP治疗组(分别 为18(0-22)vs. 14(0-22)天 ;P=0.045)。另一方面,在ICU死亡方面两组之间无显著性差异(21.8% vs. 24.4%;OR为0.844;95%CI为0.548-1.300;P=0.443)。

该研究结果表明采用PMX-HP治疗可以降低感染性休克患者的全因住院死亡率和缩短入住ICU的时间。

原始出处:

Yoshihiko Nakamura,et al. Potential survival benefit of polymyxin B hemoperfusion in patients with septic shock: a propensity-matched cohort study.Critical Care.2017. https://ccforum.biomedcentral.com/articles/10.1186/s13054-017-1712-3

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  5. 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    2017-06-08 医鸣惊人

    学习了

    0

  6. 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    2017-06-08 187****0626

    补液,感染性休克其实很难纠正的

    0

  7. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDcohE5MKT1FYlH69x7qib45icLgBDMANxIiauEA62nuQI1eE8Ez2rO3yqOkRLH6ha6Lw0x1IBRm0N7g/0, createdBy=e1ff2033933, createdName=187****0626, createdTime=Thu Jun 08 07:18:11 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208017, encodeId=382320801e4e, content=目前本医院好像没有药物~, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KzAtF5y5whDTajcUxtIxiaXPiae2aeVQEXPJtibI9SCht0TvsLsHUsgX4uSCZPGatawfPLsfKsYjLn9/0, createdBy=58d41952669, createdName=1e11a590m79(暂无匿称), createdTime=Thu Jun 08 07:17:45 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=207988, encodeId=1fd420e98824, content=学习,提高了认识, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/21/39b6a0099eb602e8ac1f7e10d5d440a9.jpg, createdBy=dee01724555, createdName=杨利洪, createdTime=Thu Jun 08 06:37:48 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=207972, encodeId=547820e97256, content=值得推荐一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBWOEtiahpXHGVdbFId5PLgK775YNA1ria3lM9KsJT6iczgIhov5sobd1Nr0raUBP58GkUDzvfDic9RCg/0, createdBy=0d021989245, createdName=189****1577, createdTime=Thu Jun 08 05:39:09 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=207934, encodeId=e9f520e934d8, content=学习了,好好研究下, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, 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=Thu Jun 08 00:13:52 CST 2017, time=2017-06-08, status=1, ipAttribution=)]
    2017-06-08 1e11a590m79(暂无匿称)

    目前本医院好像没有药物~

    0

  8. 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createdBy=583d24724321, createdName=charl1234575, createdTime=Wed Mar 28 11:29:00 CST 2018, time=2018-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989820, encodeId=804b198982093, content=<a href='/topic/show?id=319c4336137' target=_blank style='color:#2F92EE;'>#多粘菌素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43361, encryptionId=319c4336137, topicName=多粘菌素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=362b271, createdName=zexyw01, createdTime=Wed Jul 19 18:29:00 CST 2017, time=2017-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928730, encodeId=8d561928e30c1, content=<a href='/topic/show?id=a4a3e628250' target=_blank style='color:#2F92EE;'>#粘菌素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, 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content=学习,提高了认识, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/21/39b6a0099eb602e8ac1f7e10d5d440a9.jpg, createdBy=dee01724555, createdName=杨利洪, createdTime=Thu Jun 08 06:37:48 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=207972, encodeId=547820e97256, content=值得推荐一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBWOEtiahpXHGVdbFId5PLgK775YNA1ria3lM9KsJT6iczgIhov5sobd1Nr0raUBP58GkUDzvfDic9RCg/0, createdBy=0d021989245, createdName=189****1577, createdTime=Thu Jun 08 05:39:09 CST 2017, time=2017-06-08, status=1, ipAttribution=), 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    2017-06-08 杨利洪

    学习,提高了认识

    0

  9. 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    2017-06-08 189****1577

    值得推荐一下

    0

  10. 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    2017-06-08 惠映实验室

    学习了,好好研究下

    0

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