院前抗血小板治疗对 ARDS 发生率的影响。
Effects of Pre-Hospital Antiplatelet Therapy on the Incidence of ARDS.
机构信息
Department of Respiratory Disease, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Interdisciplinary Biophysics Graduate Program, The Ohio State University, Columbus, Ohio.
出版信息
Respir Care. 2020 Jul;65(7):1039-1045. doi: 10.4187/respcare.07177. Epub 2020 Feb 11.
BACKGROUND
Clinical observations on the potential of pre-hospital antiplatelet therapy in preventing ARDS have been inconsistent. To further the correlation between antiplatelet therapy and ARDS, we conducted a meta-analysis to evaluate the effects of pre-hospital antiplatelet therapy on subjects with ARDS.
METHODS
A literature search in major data banks was performed. We included prospective and retrospective cohorts, case-control trials, and randomized controlled trials that compared the ARDS incidence in subjects with or without pre-hospital antiplatelet agents.
RESULTS
Meta-analysis of 7 studies (a total of 30,291 subjects) showed significantly lower odds of ARDS in the pre-hospital antiplatelet therapy group compared with subjects with no pre-hospital antiplatelet therapy (odds ratio 0.68, 95% CI 0.56-0.83; < .001). However, ARDS mortalities in the hospital and ICUs were not affected.
CONCLUSIONS
These findings indicated that pre-hospital antiplatelet therapy was associated with a reduced rate of ARDS but had no effect on the mortality in the subjects at high risk.
背景
临床上观察到，院前抗血小板治疗预防 ARDS 的效果并不一致。为了进一步研究抗血小板治疗与 ARDS 之间的相关性，我们进行了一项荟萃分析，以评估院前抗血小板治疗对 ARDS 患者的影响。
方法
我们在主要数据库中进行了文献检索。纳入前瞻性和回顾性队列研究、病例对照试验和随机对照试验，比较了有或无院前抗血小板药物治疗的 ARDS 发生率。
结果
对 7 项研究（共 30291 例患者）进行荟萃分析显示，与无院前抗血小板治疗的患者相比，院前抗血小板治疗组发生 ARDS 的几率显著降低（比值比 0.68，95%CI 0.56-0.83；<0.001）。然而，在医院和 ICU 的 ARDS 死亡率并未受到影响。
结论
这些发现表明，院前抗血小板治疗与 ARDS 发生率降低相关，但对高危患者的死亡率没有影响。
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