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厄托昔布治疗与主动脉夹层腔内修复术后患者缺氧事件的相关性。

Association of Etoricoxib treatment and incident hypoxia in patients with aortic dissection undergoing endovascular aortic repair.

机构信息

Department of Cardiology, The Third People's Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou, Guangdong, China.

Department of Cardiology, The Third People's Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou, Guangdong, China.

出版信息

Biomed Pharmacother. 2021 Jul;139:111625. doi: 10.1016/j.biopha.2021.111625. Epub 2021 Apr 23.

Abstract

OBJECTIVE

The current study was to evaluate the association of Etoricoxib treatment and incident hypoxia among type-B aortic dissection (AD) patients undergoing endovascular aortic repair (EVAR).

METHODS

Patients undergoing EVAR were retrospectively recruited. Based on Etoricoxib use, patients were divided into the non-treated and Etoricoxib-treated groups. Baseline characteristics including demographics, laboratory parameters, characteristics of aortic computer tomography and echocardiography, medications used, and procedural characteristics were collected from the electronic health record.

RESULTS

Compared to non-treated group (n = 36), prevalence of obesity and fever at baseline was higher in Etoricoxib-treated group (n = 24; P < 0.05). Mean number of neutrophils, and mean serum CRP and D-dimer levels were higher in Etoricoxib-treated group (P < 0.05). The overall incidence of hypoxia was lower in Etoricoxib-treated group (44.4% vs 33.4%, P < 0.05). Increase in neutrophils count, serum CRP and D-dimer levels was associated with incident hypoxia, with an odds ratio (OR) of 1.36 (95% confidence interval [CI] 1.07-1.65), 1.44 (95% CI 1.12-1.78) and 1.25 (95% CI 1.01-1.47) respectively. In unadjusted model, Etoricoxib use was associated with a 44% lower odds of incident hypoxia. After adjustment for inflammatory markers, the association between Etoricoxib and incident hypoxia was non-significant, with OR of 0.95% and 95% CI of 0.78-1.06.

CONCLUSION

Compared to patients who did not receive Etoricoxib during hospitalization, those treated with Etoricoxib had lower incidence of hypoxia, which might be attributed to its anti-inflammatory effects.

摘要

目的

本研究旨在评估托昔布治疗与接受血管内主动脉修复术(EVAR)的 B 型主动脉夹层(AD)患者发生缺氧的关系。

方法

回顾性招募接受 EVAR 的患者。根据托昔布的使用情况,患者分为未治疗组和托昔布治疗组。从电子健康记录中收集基线特征,包括人口统计学、实验室参数、主动脉计算机断层扫描和超声心动图特征、使用的药物和手术特征。

结果

与未治疗组(n=36)相比,托昔布治疗组(n=24)基线时肥胖和发热的患病率更高(P<0.05)。托昔布治疗组的中性粒细胞数、血清 CRP 和 D-二聚体水平均较高(P<0.05)。托昔布治疗组缺氧的总发生率较低(44.4%比 33.4%,P<0.05)。中性粒细胞计数、血清 CRP 和 D-二聚体水平的增加与缺氧的发生相关,比值比(OR)分别为 1.36(95%可信区间[CI]为 1.07-1.65)、1.44(95% CI 为 1.12-1.78)和 1.25(95% CI 为 1.01-1.47)。在未调整模型中,托昔布的使用与缺氧的发生几率降低 44%相关。在调整炎症标志物后,托昔布与缺氧的发生之间的关联无统计学意义,OR 为 0.95%,95% CI 为 0.78-1.06。

结论

与住院期间未接受托昔布治疗的患者相比,接受托昔布治疗的患者缺氧发生率较低,这可能归因于其抗炎作用。

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