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牛磺酸补充对肝移植后谵妄的影响:一项随机对照试验。

The effect of taurine supplementation on delirium post liver transplantation: A randomized controlled trial.

机构信息

Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; Shiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Shiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Clin Nutr. 2022 Oct;41(10):2211-2218. doi: 10.1016/j.clnu.2022.07.042. Epub 2022 Aug 7.

Abstract

BACKGROUND & AIMS: Delirium is a prevalent complication of liver transplantation (LT). It may enhance the risk of morbidity and mortality. Taurine is considered to have antioxidant and neuroprotective activities. The aim of this study was to evaluate taurine supplementation effect on post-LT delirium.

METHODS

Patients older than 18 years old who had received LT in Abu-Ali Sina transplantation center in Shiraz, Iran from September 2020 to June 2021, were enrolled in this double-blinded randomized clinical trial. Exclusion criteria was known hypersensitivity to taurine, pregnancy or breast-feeding and death within 72 h post-LT. Patients were randomly divided into two groups, each received 2 g/day placebo or taurine from the first day post-LT for 30 days. Delirium was assessed using Confusion Assessment Method-Intensive Care Unit (CAM-ICU). Mortality and rejection rates and length of Intensive Transplantation Unit (ITU) and hospital stays were evaluated within one month after transplantation.

RESULTS

Two hundred and seven patients were divided into two groups. Twenty-eight and 23 patients were excluded due to their refuse to participate in the study and death within 72 h post-LT, respectively. Delirium rate within the first month was 23.08% and was significantly lower in taurine group (9.46%) compared with placebo (35.36%, P = 0.012). Length of ITU stay was significantly higher among delirious patients (P = 0.015) in this analysis.

CONCLUSION

we reached to the result that taurine can prevent post-LT delirium, dramatically. Placebo receiving and longer stay in ITU were the only independent risk factors in this trial.

REGISTRATION NUMBER OF CLINICAL TRIAL

The study was registered at the Iranian Registry of Clinical Trials (IRCT20200312046755N1; http://www.irct.ir/).

摘要

背景与目的

肝移植(LT)后谵妄是一种普遍的并发症。它可能会增加发病率和死亡率。牛磺酸被认为具有抗氧化和神经保护作用。本研究旨在评估牛磺酸补充对 LT 后谵妄的影响。

方法

本双盲随机临床试验纳入了 2020 年 9 月至 2021 年 6 月在伊朗设拉子阿布阿里西纳移植中心接受 LT 的年龄大于 18 岁的患者。排除标准为已知对牛磺酸过敏、妊娠或哺乳期以及 LT 后 72 小时内死亡。患者被随机分为两组,每组在 LT 后第 1 天开始每天接受 2 克安慰剂或牛磺酸,持续 30 天。使用重症监护病房谵妄评估方法(CAM-ICU)评估谵妄。在移植后 1 个月内评估死亡率、排斥率和重症监护移植病房(ITU)及住院时间。

结果

共有 207 例患者分为两组。由于拒绝参加研究和 LT 后 72 小时内死亡,分别有 28 例和 23 例患者被排除。第一个月内谵妄发生率为 23.08%,牛磺酸组(9.46%)明显低于安慰剂组(35.36%,P=0.012)。在这项分析中,发生谵妄的患者的 ITU 住院时间明显更长(P=0.015)。

结论

我们的研究结果表明,牛磺酸可以显著预防 LT 后谵妄。在这项试验中,接受安慰剂和 ITU 住院时间延长是唯一的独立危险因素。

临床试验注册号

该研究在伊朗临床试验注册中心(IRCT20200312046755N1;http://www.irct.ir/)注册。

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