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Am J Cardiol：浙医二院王建安Meta分析称，七因素与TAVI术后严重出血有关

2017-07-05 朱柳媛 中国循环杂志

TAVI术后血管并发症
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浙江大学医学院附属第二医院王建安教授等公布的一项Meta分析提示，对于接受经导管主动脉瓣植入（TAVI）手术的患者，≥90岁、女性、鞘管直径>19 Fr、慢性肾脏病、经心尖途径、血管并发症和循环支持7个因素是术后早期严重出血的预测因素。

浙江大学医学院附属第二医院王建安教授等公布的一项Meta分析提示，对于接受经导管主动脉瓣植入（TAVI）手术的患者，≥90岁、女性、鞘管直径>19 Fr、慢性肾脏病、经心尖途径、血管并发症和循环支持7个因素是术后早期严重出血的预测因素。

分析表明，血管并发症（RR=2.97）和需要循环支持（RR=3.39）是术后严重出血的强烈预测因素。

慢性肾脏病（RR=1.94）和经心尖途径（RR=1.82）是中等强度预测因素，有慢性肾脏病或经心尖途径接受TAVI的患者术后严重出血的风险几乎增倍。

年龄≥90岁（RR=1.17）、女性（RR=1.13）、鞘管直径>19 Fr（RR=1.19）则是术后严重出血相对较弱的预测因素。

这一Meta分析共覆盖47项相关研究，65 209例患者，各研究中TAVI术后严重出血发生率平均为11%。

研究者认为，这一分析结果可为临床上TAVI术后严重出血的预防和管理提供一定的指导信息。

原始出处：

Sun Y, Liu X, Chen Z, etal. Meta-analysis of Predictors of Early Severe Bleeding in Patients Who Underwent Transcatheter Aortic Valve Implantation. Am J Cardiol. 2017 May 30. pii: S0002-9149(17)30871-8. doi: 10.1016/j.amjcard.2017.05.035. 

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    2018-05-22 仁者大医

    #Cardiol#

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    2017-10-13 guojianrong

    #Meta#

    0

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    2018-06-10 一闲

    #MET#

    0

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    2017-07-07 ms4964546379600229

    #浙医二院#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1781781, encodeId=76ff1e81781b0, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, 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=Tue May 22 10:43:00 CST 2018, time=2018-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887681, encodeId=5340188e68110, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Fri Oct 13 03:43:00 CST 2017, time=2017-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896097, encodeId=dc01189609eed, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sun Jun 10 15:43:00 CST 2018, time=2018-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580280, encodeId=69cf1580280f8, content=<a href='/topic/show?id=13a46550530' target=_blank style='color:#2F92EE;'>#浙医二院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65505, encryptionId=13a46550530, topicName=浙医二院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=609b16615044, createdName=ms4964546379600229, createdTime=Fri Jul 07 03:43:00 CST 2017, time=2017-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218853, encodeId=fc012188538c, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Jul 05 14:47:08 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218850, encodeId=0ad32188503c, content=谢谢分享，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=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jul 05 14:46:54 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218825, encodeId=f00c21882558, content=学习一下知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Wed Jul 05 13:53:52 CST 2017, time=2017-07-05, status=1, ipAttribution=)]
    2017-07-05 131****1460

    学习了受益匪浅。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1781781, encodeId=76ff1e81781b0, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, 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=Tue May 22 10:43:00 CST 2018, time=2018-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887681, encodeId=5340188e68110, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Fri Oct 13 03:43:00 CST 2017, time=2017-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896097, encodeId=dc01189609eed, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sun Jun 10 15:43:00 CST 2018, time=2018-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580280, encodeId=69cf1580280f8, content=<a href='/topic/show?id=13a46550530' target=_blank style='color:#2F92EE;'>#浙医二院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65505, encryptionId=13a46550530, topicName=浙医二院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=609b16615044, createdName=ms4964546379600229, createdTime=Fri Jul 07 03:43:00 CST 2017, time=2017-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218853, encodeId=fc012188538c, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Jul 05 14:47:08 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218850, encodeId=0ad32188503c, content=谢谢分享，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=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jul 05 14:46:54 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218825, encodeId=f00c21882558, content=学习一下知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Wed Jul 05 13:53:52 CST 2017, time=2017-07-05, status=1, ipAttribution=)]
    2017-07-05 明月清辉

    谢谢分享，学习了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1781781, encodeId=76ff1e81781b0, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, 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=Tue May 22 10:43:00 CST 2018, time=2018-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887681, encodeId=5340188e68110, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Fri Oct 13 03:43:00 CST 2017, time=2017-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896097, encodeId=dc01189609eed, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sun Jun 10 15:43:00 CST 2018, time=2018-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1580280, encodeId=69cf1580280f8, content=<a href='/topic/show?id=13a46550530' target=_blank style='color:#2F92EE;'>#浙医二院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65505, encryptionId=13a46550530, topicName=浙医二院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=609b16615044, createdName=ms4964546379600229, createdTime=Fri Jul 07 03:43:00 CST 2017, time=2017-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218853, encodeId=fc012188538c, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Jul 05 14:47:08 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218850, encodeId=0ad32188503c, content=谢谢分享，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=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jul 05 14:46:54 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218825, encodeId=f00c21882558, content=学习一下知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Wed Jul 05 13:53:52 CST 2017, time=2017-07-05, status=1, ipAttribution=)]
    2017-07-05 flysky120

    学习一下知识了

    0