J Gastroenterology: 治疗代偿性腹水可减轻肌肉减少症并改善失代偿性肝硬化患者的生存率

2020-02-06 不详 MedSci原创

本项研究旨在调查难治性腹水患者对托普普坦对环利尿剂和醛固酮拮抗剂无反应的情况下,患者骨骼肌容量随时间变化。

背景
本项研究旨在调查难治性腹水患者对托普普坦对环利尿剂和醛固酮拮抗剂无反应的情况下,患者骨骼肌容量随时间变化。

方法
这项回顾性研究包括42例因难治性腹水和/或肝水肿接受托伐普坦治疗的患者,在开始托伐普坦治疗之前和之后3个月进行了计算机体层摄影(CT)检查。每年骨骼肌指数的时程变化[ΔSMI(%)]计算如下:ΔSMI(%)=(最终CT扫描时的SMI-初始CT扫描时的SMI)/初始CT扫描时的SMI×100/年CT扫描。

结果
符合条件的患者为23名男性和19名女性,中位年龄为71岁(21-94岁)。中位随访期为22.7个月(范围3.5-54.6)。应答者组的ΔSMI(%)显着高于无应答者组。多变量分析显示对托伐普坦的反应是与肌肉质量增加相关的独立且重要的因素[比值比(OR)20.364;95%CI 2.327–178.97; P= 0.006]。响应者组中托伐普坦的总生存期显着高于无反应者组。多因素分析表明,对托伐普坦治疗的反应是良好预后的重要因素(OR 3.884; 95%CI 1.264-11.931;P= 0.018)。在速尿的剂量和ΔSMI(%)之间观察到显着的负相关(P= 0.014)。

结论
托伐普坦治疗难治性腹水可减缓少肌症的进展并改善失代偿性肝硬化患者的预后。

原始出处:

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createdBy=d18723374958, createdName=shizhenshan, createdTime=Thu Oct 08 01:49:00 CST 2020, time=2020-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712308, encodeId=3a8d1e12308be, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Sep 02 17:49:00 CST 2020, time=2020-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072888, encodeId=325120e288806, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Tue Oct 20 06:49:00 CST 2020, time=2020-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2077566, encodeId=980720e756635, content=<a href='/topic/show?id=94c7253e768' target=_blank style='color:#2F92EE;'>#代偿性肝硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25377, encryptionId=94c7253e768, topicName=代偿性肝硬化)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/0EDD6BA8A8C6A0C23E8ABC8BA5331A25/100, createdBy=d37d2500154, createdName=ms5106640509429053, createdTime=Wed Jan 06 04:49:00 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256746, encodeId=60711256e4684, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Sat Feb 08 11:49:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393394, encodeId=5469139339495, content=<a href='/topic/show?id=e2f4809e7e9' target=_blank style='color:#2F92EE;'>#肌肉减少症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80977, encryptionId=e2f4809e7e9, topicName=肌肉减少症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIOca9icPByKxo3ZRUrvuibf7tWt7EScQ1NEiaKy4NCUctSU2jDjOayLicDIaicwUxaQhJ1SZKdEevgjRg/132, createdBy=4f272500131, createdName=若水123, createdTime=Sat Feb 08 11:49:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502153, encodeId=61b71502153f4, content=<a href='/topic/show?id=e550442591f' target=_blank style='color:#2F92EE;'>#失代偿性肝硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44259, encryptionId=e550442591f, topicName=失代偿性肝硬化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ecdc9510146, createdName=lizhou0207, createdTime=Sat Feb 08 11:49:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504924, encodeId=91e415049246c, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Feb 08 11:49:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046431, encodeId=1dab104643115, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Feb 06 23:49:00 CST 2020, time=2020-02-06, status=1, ipAttribution=)]
    2020-10-20 许安
  5. 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topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Tue Oct 20 06:49:00 CST 2020, time=2020-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2077566, encodeId=980720e756635, content=<a href='/topic/show?id=94c7253e768' target=_blank style='color:#2F92EE;'>#代偿性肝硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25377, encryptionId=94c7253e768, topicName=代偿性肝硬化)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/0EDD6BA8A8C6A0C23E8ABC8BA5331A25/100, createdBy=d37d2500154, createdName=ms5106640509429053, createdTime=Wed Jan 06 04:49:00 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256746, encodeId=60711256e4684, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Sat Feb 08 11:49:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393394, encodeId=5469139339495, content=<a href='/topic/show?id=e2f4809e7e9' target=_blank style='color:#2F92EE;'>#肌肉减少症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80977, encryptionId=e2f4809e7e9, topicName=肌肉减少症)], attachment=null, authenticateStatus=null, 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style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Feb 08 11:49:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046431, encodeId=1dab104643115, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Feb 06 23:49:00 CST 2020, time=2020-02-06, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2064979, encodeId=6a0020649e9b2, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sat Jan 09 06:49:00 CST 2021, time=2021-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647099, encodeId=4429164e099ed, content=<a href='/topic/show?id=fd6d809e535' target=_blank style='color:#2F92EE;'>#肌肉减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80975, encryptionId=fd6d809e535, topicName=肌肉减少)], attachment=null, authenticateStatus=null, createdAvatar=null, 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href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Sat Feb 08 11:49:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393394, encodeId=5469139339495, content=<a href='/topic/show?id=e2f4809e7e9' target=_blank style='color:#2F92EE;'>#肌肉减少症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80977, encryptionId=e2f4809e7e9, topicName=肌肉减少症)], attachment=null, authenticateStatus=null, 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style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Feb 08 11:49:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046431, encodeId=1dab104643115, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Feb 06 23:49:00 CST 2020, time=2020-02-06, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2064979, encodeId=6a0020649e9b2, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sat Jan 09 06:49:00 CST 2021, time=2021-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647099, encodeId=4429164e099ed, content=<a href='/topic/show?id=fd6d809e535' target=_blank style='color:#2F92EE;'>#肌肉减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80975, encryptionId=fd6d809e535, topicName=肌肉减少)], attachment=null, authenticateStatus=null, createdAvatar=null, 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style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Feb 08 11:49:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046431, encodeId=1dab104643115, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Thu Feb 06 23:49:00 CST 2020, time=2020-02-06, status=1, ipAttribution=)]
    2020-02-06 guging

    谢谢!最新的信息读起来就是收获大

    0

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本研究探究了缬沙坦治疗对袢利尿剂和醛固酮拮抗剂无反应的顽固性腹水患者骨骼肌体积的变化。

J Gastroenterol Hepatol:在肝硬化肝水肿患者中,血清尿素水平和尿钠排泄与患者对tolvaptan药物应答密切相关

本研究表明,在肝硬化肝水肿患者中,血清尿素水平和尿钠排泄与患者对tolvaptan药物应答密切相关。

FDA批准大冢tolvaptan用于治疗常染色体显性多囊肾病

大冢(Otsuka Pharma)公司的托伐普坦(tolvaptan)获FDA批准用于治疗常染色体显性多囊肾病(ADPKD),成为美国第一款ADPKD药物。

NEJM:托伐坦用于多囊肾病效果佳

     Vicente E. Torres博士等人12月20日发表在《新英格兰医学杂志》上的一项最新研究表明,托伐坦(Tolvaptan)用于常染色体显性多囊肾病,可以明显延缓肾功能衰退。   随着常染色体显性多囊肾病(ADPKD)的病情进展,患者常并发疼痛、高血压和肾功能衰竭。临床前试验表明,垂体后叶素V2受体拮抗剂可抑制肾囊肿的生长,延缓肾功能的下降。