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对乙酰氨基酚对脓毒症患者急性肾损伤的预防作用。

Effect of Acetaminophen on the Prevention of Acute Kidney Injury in Patients With Sepsis.

作者信息

Patanwala Asad E, Aljuhani Ohoud, Bakhsh Hussain, Erstad Brian L

机构信息

1 The University of Arizona, Tucson, AZ, USA.

2 King Abdulaziz University, Jeddah, Saudi Arabia.

出版信息

Ann Pharmacother. 2018 Jan;52(1):48-53. doi: 10.1177/1060028017728298. Epub 2017 Aug 24.

Abstract

BACKGROUND

Acute kidney injury (AKI) commonly occurs in patients with sepsis. Acetaminophen (APAP) has been shown to inhibit lipid peroxidation and, thus, may be renal protective in patients with sepsis.

OBJECTIVE

The objective of this study was to determine the effect of APAP on AKI in patients with sepsis.

METHODS

This was a retrospective cohort study conducted at 2 affiliated academic medical centers in the United States. Adult patients who were admitted to the intensive care unit with a diagnosis of severe sepsis were included. Patients were categorized based on whether APAP was received within the first 7 days of hospitalization (APAP or no APAP groups). The primary outcome measure was occurrence or increase in AKI stage from admission. Multivariate logistic regression analyses were used to adjust for potential confounders.

RESULTS

There were 238 patients who were included in the study cohort. Of these, 122 received APAP and 116 did not receive APAP. AKI or exacerbation occurred in 16.4% (n = 20) of patients in the APAP group and 19.8% (n = 23) of patients in the no APAP group ( P = 0.505). After adjusting for the most important confounders, there was no significant association between APAP use and AKI (odds ratio = 1.2; 95% CI = 0.6-2.4; P = 0.639).

CONCLUSION

APAP use in critically ill patients with sepsis may not reduce the occurrence or exacerbation of AKI.

摘要

背景

急性肾损伤(AKI)常见于脓毒症患者。对乙酰氨基酚(APAP)已被证明可抑制脂质过氧化,因此可能对脓毒症患者具有肾脏保护作用。

目的

本研究的目的是确定APAP对脓毒症患者急性肾损伤的影响。

方法

这是一项在美国2家附属学术医疗中心进行的回顾性队列研究。纳入入住重症监护病房且诊断为严重脓毒症的成年患者。根据患者在住院前7天内是否接受APAP进行分组(APAP组或无APAP组)。主要结局指标是入院时AKI分期的发生或加重情况。采用多因素逻辑回归分析来调整潜在混杂因素。

结果

238例患者纳入研究队列。其中,122例接受了APAP,116例未接受APAP。APAP组16.4%(n = 20)的患者发生AKI或病情加重,无APAP组为19.8%(n = 23)(P = 0.505)。在对最重要的混杂因素进行调整后,APAP的使用与AKI之间无显著关联(比值比 = 1.2;95%可信区间 = 0.6 - 2.4;P = 0.639)。

结论

在重症脓毒症患者中使用APAP可能不会降低AKI的发生或加重风险。

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