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卡培他滨对急性心力衰竭患者肺淤血程度的影响。

Effects of Carperitide on Degree of Pulmonary Congestion in Treatment of Acute Heart Failure.

机构信息

Department of Cardiology, Kurashiki Central Hospital.

出版信息

Circ J. 2018 Jul 25;82(8):2079-2088. doi: 10.1253/circj.CJ-18-0057. Epub 2018 May 24.

Abstract

BACKGROUND

Carperitide is used to treat acute heart failure (AHF) in Japan. Whether the degree of pulmonary congestion is associated with the effects of carperitide on AHF is unclear.

METHODS AND RESULTS

We retrospectively investigated the in-hospital outcomes and prognoses of 742 patients hospitalized for AHF between February 2015 and January 2017 and classified them into carperitide and non-carperitide groups, stratified according to the degree of pulmonary congestion. The median follow-up duration after admission was 231 days. In patients with moderate-severe pulmonary congestion, the rate of remaining congestion on chest X-ray at discharge was lower in the carperitide group than in the non-carperitide group (1.5% vs. 9.0%, P=0.004). Also, the carperitide group had significant reduction in a composite of all-cause death or rehospitalization for HF (adjusted hazard ratio, 0.62; 95% CI: 0.41-0.93; P=0.02). In patients with no-mild pulmonary congestion, carperitide was not associated with better clinical outcome.

CONCLUSIONS

In the treatment of AHF with moderate-severe pulmonary congestion, carperitide is associated with more effective decongestion in the short term and better prognosis in the long term.

摘要

背景

卡贝缩宫素在日本被用于治疗急性心力衰竭(AHF)。卡贝缩宫素对 AHF 的疗效是否与肺充血程度有关尚不清楚。

方法和结果

我们回顾性调查了 2015 年 2 月至 2017 年 1 月期间因 AHF 住院的 742 例患者的住院期间结局和预后,并根据肺充血程度将其分为卡贝缩宫素组和非卡贝缩宫素组。入院后中位随访时间为 231 天。在中重度肺充血患者中,卡贝缩宫素组在出院时胸部 X 线仍存在充血的比例低于非卡贝缩宫素组(1.5%比 9.0%,P=0.004)。此外,卡贝缩宫素组全因死亡或因 HF 再住院的复合终点发生率显著降低(调整后的危险比,0.62;95%CI:0.41-0.93;P=0.02)。在无-轻度肺充血患者中,卡贝缩宫素与更好的临床结局无关。

结论

在中重度肺充血的 AHF 治疗中,卡贝缩宫素在短期内可更有效地减轻充血,长期预后更好。

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