卡维地洛的使用与肝硬化腹水患者生存改善的相关性

发布时间：2018-03-26 04:55

本文选题：卡维地洛　切入点：普萘洛尔　出处：《实用医学杂志》2017年18期

【摘要】：目的探讨卡维地洛的使用与肝硬化腹水患者生存改善的相关性。方法采用回顾性队列研究方法,随访调查2010年3月1日至2011年3月1日接受治疗的158例肝硬化腹水患者5年内生存状况。收集并整理患者电子病历和随访资料,按照不同治疗药物分成卡维地洛组和普萘洛尔组,比较两组的基线、治疗及随访资料,绘制生存曲线表示两组患者累计生存率的变化,采用COX回归法分析影响肝硬化腹水患者生存状况的因素。结果卡维地洛组的年龄、BMI、肿静脉压力梯度(HVPG)下降值、糖尿病的患病率高于普萘洛尔组,上消化道静脉破裂再出血率低于普萘洛尔组(P0.05);Kaplan Meier生存函数显示卡维地洛组患者的累计生存率高于普萘洛尔组(P0.05)。COX回归分析结果显示肝硬化腹水患者服用卡维地洛为生存的保护性因素,危险度比[RR=0.714,95%CI(0.565~0.902),P=0.013]。结论卡维地洛能显著缓解肝硬化患者上消化道静脉破裂出血和腹水状况,相比普洛萘尔能有效降低肝脏相关致死率,改善患者预后,具有更好的疗效。
[Abstract]:Objective to investigate the correlation between carvedilol use and survival improvement in cirrhotic patients with ascites. Methods retrospective cohort study was used. A follow-up study was conducted on 158 patients with cirrhosis and ascites who received treatment from March 1, 2010 to March 1, 2011. The patient's electronic medical records and follow-up data were collected and sorted out. Carvedilol group and propranolol group were divided into two groups according to different treatment drugs. The baseline, treatment and follow-up data were compared, and survival curves were drawn to show the change of cumulative survival rate in both groups. COX regression was used to analyze the factors influencing the survival status of patients with ascites of liver cirrhosis. Results in carvedilol group, the age and pressure gradient of hv were decreased, and the prevalence of diabetes was higher than that of propranolol group, and the incidence of diabetes mellitus was higher than that of propranolol group. The cumulative survival rate of patients with upper gastrointestinal venous rupture was lower than that of patients with propranolol treated with carvedilol using Kaplan Meier survival function. The results of regression analysis showed that carvedilol was higher in cirrhotic patients with ascites than in patients with propranolol. Protective factors for survival, Conclusion Carvedilol can significantly relieve the bleeding and ascites of upper gastrointestinal venous rupture in patients with liver cirrhosis. Compared with propranolol, it can effectively reduce the fatality rate of liver and improve the prognosis of the patients.
【作者单位】：广东医科大学附属医院消化内科;广东医科大学附属医院心血管内科;广东省佛山市大良医院消化科;
【基金】：广东佛山市医学类科技攻关项目(编号:201308256)
【分类号】：R575.2

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