J Am Heart Assoc:急性心衰患者研究发现 丹参或增加死亡风险

2019-08-06 朱柳媛 中国循环杂志

《美国心脏协会杂志》发表的一项针对China PEACE回顾性心衰研究的分析结果表明,在我国急性心衰住院患者中,74.7%应用中药,其中83.3%是静脉注射液。

《美国心脏协会杂志》发表的一项针对China PEACE回顾性心衰研究的分析结果表明,在我国急性心衰住院患者中,74.7%应用中药,其中83.3%是静脉注射液。

在所有中药中,丹参应用最多,占51.2%,其次是三七(17.1%)、银杏(9.7%)、黄芪(7.4%)、红花(6.3%)。

但是,研究者发现,丹参对急性心衰患者可能有明显的不良影响。应用丹参的患者发生出血事件和死亡的风险分别增加39%和36%,其中应用丹参≥2天者出血风险明显增加。

研究显示,大约1/4(24.2%)的患者至少应用两种中药,最常应用的中药组合是丹参+三七(8.2%)或黄芪(4.4%)。

在该研究覆盖的全国189家医院中,几乎所有(99.4%)的医院都用中药。

不同医院的中药应用率存在差异,最高者与最低者相差3倍以上;可做心脏搭桥术的医院中药应用率相对较低。

急性心衰患者平均住院9天,但应用中药的平均时间长达6天。大多数患者是在住院第一天应用中药。12.3%的患者在出院时开了中药。

合并冠心病、中风、高血压的患者中,中药应用的可能性最大(OR分别为1.73、1.32、1.21)。

慢性阻塞性肺病、糖尿病、慢性肾脏病、癌症患者较少应用中药。

有胸痛症状的病人更可能应用中药,而静息时气喘和有肺部啰音的病人较少用中药。

研究显示,在这些患者中,中药的应用不影响有循证证据的心衰治疗措施的应用。

研究者指出,我国心衰患者住院比较频繁,中药应用程度却如此之高,亟需进一步开展研究来评估中药在急性心衰住院患者中的安全性和有效性,以及寻找中药在临床实践中的标准应用方法。

该研究从全国189家医院纳入10004例急性心衰住院患者,其平均年龄为73岁,女士占48.9%。

原始出处:
Yu Y1,2, Spatz ES3,4, Tan Q5,6,et al.Traditional Chinese Medicine Use in the Treatment of Acute Heart Failure in Western Medicine Hospitals in China: Analysis From the China PEACE Retrospective Heart Failure Study.J Am Heart Assoc. 2019 Aug 6;8(15):e012776. doi: 10.1161/JAHA.119.012776. Epub 2019 Jul 31.

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    2019-08-17 146c765cm75暂无昵称

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    0

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    2019-08-08 zhaojie88
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1753486, encodeId=ac991e53486dd, content=<a href='/topic/show?id=6a57e33772b' target=_blank style='color:#2F92EE;'>#研究发现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73377, encryptionId=6a57e33772b, topicName=研究发现)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e1736602208, createdName=hanhaisha2020, createdTime=Fri Jul 17 01:22:00 CST 2020, time=2020-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371418, encodeId=a7aa3e1418d0, content=我国心衰患者住院比较频繁,中药应用程度却如此之高,亟需进一步开展研究来评估中药在急性心衰住院患者中的安全性和有效性,以及寻找中药在临床实践中的标准应用方法。确实值得反思与警惕。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ff45165790, createdName=146c765cm75暂无昵称, createdTime=Sat Aug 17 23:29:37 CST 2019, time=2019-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255892, encodeId=100a1255892ae, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Thu Aug 08 12:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357245, encodeId=4269135e245d8, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Aug 08 12:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1359798, encodeId=98df1359e98c4, content=<a href='/topic/show?id=5aa95229085' target=_blank style='color:#2F92EE;'>#急性心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52290, encryptionId=5aa95229085, topicName=急性心衰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Aug 08 12:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373452, encodeId=f93013e345237, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=14, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Thu Aug 08 12:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563123, encodeId=1a6c156312378, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Aug 08 12:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1753486, encodeId=ac991e53486dd, content=<a href='/topic/show?id=6a57e33772b' target=_blank style='color:#2F92EE;'>#研究发现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73377, encryptionId=6a57e33772b, topicName=研究发现)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e1736602208, createdName=hanhaisha2020, createdTime=Fri Jul 17 01:22:00 CST 2020, time=2020-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371418, encodeId=a7aa3e1418d0, content=我国心衰患者住院比较频繁,中药应用程度却如此之高,亟需进一步开展研究来评估中药在急性心衰住院患者中的安全性和有效性,以及寻找中药在临床实践中的标准应用方法。确实值得反思与警惕。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ff45165790, createdName=146c765cm75暂无昵称, createdTime=Sat Aug 17 23:29:37 CST 2019, time=2019-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255892, encodeId=100a1255892ae, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Thu Aug 08 12:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357245, encodeId=4269135e245d8, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Aug 08 12:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1359798, encodeId=98df1359e98c4, content=<a href='/topic/show?id=5aa95229085' target=_blank style='color:#2F92EE;'>#急性心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52290, encryptionId=5aa95229085, topicName=急性心衰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Aug 08 12:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373452, encodeId=f93013e345237, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=14, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=467c360, createdName=yuanming7, createdTime=Thu Aug 08 12:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563123, encodeId=1a6c156312378, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Aug 08 12:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=)]
    2019-08-08 slcumt

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