Crit Care Med:体外膜肺氧合治疗心肌梗死后生存率的预测 !

2018-01-28 xing.T MedSci原创

由此可见,在这种单中心研究重,几个重要的协变量与急性心肌梗死合并心源性休克接受体外膜式氧合治疗的患者生存率的改善相关。

急性心肌梗死是心源性休克最常见的原因。虽然急性心肌梗死合并心源性休克患者在过去的十年中采用体外膜式氧合治疗的病人数量有所增加,但具体的生存数据较为缺乏。近日,危重病医学领域权威杂志Critical Care Medicine上发表了一篇研究文章,研究人员试图分析这类患者人群生存率的独立相关因素。
 
该研究是在一个教学医院内完成的回顾性临床研究,研究对象为急性心肌梗死合并心源性休克的成年患者,并且这些患者从2008年6月到2016年9月采用体外膜式氧合支持治疗。该研究评估了十四个个体变量与主要终点之间的相关性,这些变量是研究团队预先设定的,最有可能影响患者生存率。研究人员还进行了受试者工作特征分析,以检验ENCOURAGE评分对该患者队列生存率的预测能力。
 
该研究的主要终点为住院生存率,共有61名患者纳入分析。37名(60.7%)患者可以脱离体外膜氧合和36名(59%)患者存活。研究人员发现小于65岁的患者存活率明显较高(比值比为14.6,95%CI为2.5-84;P=0.003),他们的体重指数小于32kg/m2(比值比为5.5,95%CI为1.2-25.4;P=0.029)和国际标准化比值小于2(比值比为7.3,95%CI为1.3-40.1;P=0.022)。在第一次注射乳酸不足3mmol/L的患者中,存活率不高(比值比为4.4,95%CI为0.6-32.6,P=0.147)。

由此可见,在这种单中心研究重,几个重要的协变量与急性心肌梗死合并心源性休克接受体外膜式氧合治疗的患者生存率的改善相关。
 
原始出处:

 
Pabst, Dirk,et al. Predicting Survival in Patients Treated With Extracorporeal Membrane Oxygenation After Myocardial Infarction.critical care medicine. https://journals.lww.com/ccmjournal/Abstract/publishahead/Predicting_Survival_in_Patients_Treated_With.96364.aspx
 
本文系梅斯医学(MedSci)原创编译整理,转载需授权!


版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=284820, encodeId=7b6828482093, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sat Feb 03 21:59:39 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256627, encodeId=e4f6125662ef4, 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=41, 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=Tue Jan 30 12:57:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1608489, encodeId=db6b160848918, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Jan 30 12:57:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283124, encodeId=42a928312428, content=厉害.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Mon Jan 29 09:07:53 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283008, encodeId=31be283008fc, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Sun Jan 28 22:29:36 CST 2018, time=2018-01-28, status=1, ipAttribution=)]
    2018-02-03 李东泽

    是很好的学习材料.不错.以后会多学习.

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=284820, encodeId=7b6828482093, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sat Feb 03 21:59:39 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256627, encodeId=e4f6125662ef4, 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=41, 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=Tue Jan 30 12:57:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1608489, encodeId=db6b160848918, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Jan 30 12:57:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283124, encodeId=42a928312428, content=厉害.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Mon Jan 29 09:07:53 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283008, encodeId=31be283008fc, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Sun Jan 28 22:29:36 CST 2018, time=2018-01-28, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=284820, encodeId=7b6828482093, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sat Feb 03 21:59:39 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256627, encodeId=e4f6125662ef4, 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=41, 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=Tue Jan 30 12:57:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1608489, encodeId=db6b160848918, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Jan 30 12:57:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283124, encodeId=42a928312428, content=厉害.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Mon Jan 29 09:07:53 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283008, encodeId=31be283008fc, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Sun Jan 28 22:29:36 CST 2018, time=2018-01-28, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=284820, encodeId=7b6828482093, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sat Feb 03 21:59:39 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256627, encodeId=e4f6125662ef4, 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=41, 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=Tue Jan 30 12:57:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1608489, encodeId=db6b160848918, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Jan 30 12:57:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283124, encodeId=42a928312428, content=厉害.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Mon Jan 29 09:07:53 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283008, encodeId=31be283008fc, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Sun Jan 28 22:29:36 CST 2018, time=2018-01-28, status=1, ipAttribution=)]
    2018-01-29 120e71dcm28暂无昵称

    厉害.学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=284820, encodeId=7b6828482093, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sat Feb 03 21:59:39 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256627, encodeId=e4f6125662ef4, 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=41, 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=Tue Jan 30 12:57:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1608489, encodeId=db6b160848918, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Jan 30 12:57:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283124, encodeId=42a928312428, content=厉害.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b4b12216028, createdName=120e71dcm28暂无昵称, createdTime=Mon Jan 29 09:07:53 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283008, encodeId=31be283008fc, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Sun Jan 28 22:29:36 CST 2018, time=2018-01-28, status=1, ipAttribution=)]
    2018-01-28 戒馋,懒,贪

    谢谢分享学习了

    0

相关资讯

Crit Care:体外膜肺氧合治疗急性失代偿性心力衰竭效果如何?

在选取的105例接受体外膜肺氧合治疗急性失代偿性心力衰竭患者中,其1年生存率为42%,但在体外膜肺氧合前序贯器官衰竭评分小于11的患者中生存率更好。体外膜肺氧合对于急性失代偿性心力衰竭患者应给予考虑,但是接受治疗的时机是至关重要的。

​AHA2017:现场证争鸣:大面积肺栓塞治疗策略应何去何从?

大面积肺栓塞(PE)属肺栓塞中极高危。对于这些患者,即刻行血栓切除术还是体外膜肺氧合(ECMO)稳定后再择期手术?

病例分享:26岁A型主动脉夹层患者几历生死

7月底,深夜,南医大二附院收治了一名特别的病人,1991年出生,男性。因胸闷大汗一小时而入院。心血管中心的张主任首先给患者做了心电图。