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聚明胶肽血液灌流治疗需要连续性肾脏替代治疗的脓毒症患者的效果:日本全国行政数据库分析。

Effects of polymyxin B hemoperfusion in patients with sepsis requiring continuous hemodiafiltration: Analysis of a nationwide administrative database in Japan.

机构信息

Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan.

Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Ther Apher Dial. 2021 Aug;25(4):384-389. doi: 10.1111/1744-9987.13655. Epub 2021 May 2.

Abstract

This study investigated sepsis patients' current status with continuous hemodiafiltration (CHDF) with or without polymyxin B hemoperfusion (PMX). We identified 17 367 adult sepsis patients treated with CHDF and PMX using the Japanese diagnosis procedure combination (DPC) database from April 2016 to March 2019. More than half of the patients in this category resulted in death in the hospital, which means that patients in this group were critically ill. Among the patients who received CHDF, the 28-day survival rate of PMX-treated patients was significantly higher than that of non-treated patients, after adjusting the patient background by propensity score matching (69.5% vs. 65.4%, p < 0.0001). Furthermore, the length of hospital stay and intensive care unit stay was significantly shorter in PMX-treated patients than that of non-treated patients. These results suggest that PMX may provide benefits to patients with severe sepsis requiring CHDF.

摘要

本研究调查了使用或不使用多粘菌素 B 血液灌流(PMX)的连续性血液透析滤过(CHDF)治疗脓毒症患者的现状。我们使用日本诊断程序组合(DPC)数据库,从 2016 年 4 月至 2019 年 3 月,确定了 17367 名接受 CHDF 和 PMX 治疗的成年脓毒症患者。该类别中超过一半的患者在医院死亡,这意味着该组患者病情危急。在接受 CHDF 的患者中,经倾向评分匹配调整患者背景后,PMX 治疗患者的 28 天生存率显著高于未治疗患者(69.5%比 65.4%,p<0.0001)。此外,PMX 治疗患者的住院时间和重症监护病房停留时间明显短于未治疗患者。这些结果表明,PMX 可能为需要 CHDF 的严重脓毒症患者带来益处。

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