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维生素B1对重症监护病房获得性肌无力患者的临床疗效

[Clinical efficacy of vitamin B1 in ICU-acquired weakness patients].

作者信息

Zhou Dandan, Guo Jianhua, Wang Xuebin

机构信息

Department of Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai 200120, China. Corresponding author: Wang Xuebin, Email:

出版信息

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024 Dec;36(12):1301-1304. doi: 10.3760/cma.j.cn121430-20240715-00596.

Abstract

OBJECTIVE

To observe the clinical efficacy of vitamin B1 in patients with ICU-acquired weakness (ICU-AW).

METHODS

A retrospective analysis was conducted to select ICU-AW patients treated with vitamin B1 in the intensive care unit (ICU) of Shanghai East Hospital, Tongji University from July 2022 to December 2023. Propensity score matching was used to match the control group and observation group at a 1 : 1 ratio, considering differences in patient age, gender, and acute physiology and chronic health evaluation II (APACHE II). The control group received conventional treatment, while the observation group received vitamin B1 in addition to conventional treatment. Comparisons were made between the two groups in terms of basic information, APACHE II scores, Medical Research Council muscle strength score (MRC), interleukin-6 (IL-6), C-reactive protein (CRP), and serum creatinine (SCr) levels before and after treatment, mechanical ventilation time, and length of ICU stay were collected and compared between the two groups.

RESULTS

A total of 30 patients with ICU-AW were included, both 15 in each group. There were no significant differences in gender, age and APACHE II score between the two groups. There were no significant differences in APACHE II score, MRC score, IL-6, CRP, SCr levels, and the duration of ventilator-assisted ventilation and ICU stay between the two groups of patients before treatment. Both groups showed improvements in APACHE II scores and MRC scores after treatment, with the observation group showing significantly greater improvement compared to the control group (APACHE II score: 10.80±1.47 vs. 12.20±1.52, MRC score: 50.40±7.10 vs. 42.00±8.78, both P < 0.05). After treatment, both groups showed significant reductions in IL-6, CRP, and SCr levels, but there were no significant differences between the observation group and control group. The observation group had significantly shorter durations of mechanical ventilation (days: 7.67±1.54 vs. 9.67±2.44, P < 0.05) and ICU stay (days: 13.33±1.72 vs. 15.13±2.56, P < 0.05) compared to the control group.

CONCLUSIONS

The use of vitamin B1 during the treatment of ICU-AW significantly improves muscle strength and reduces the duration of mechanical ventilation and ICU stay.

摘要

目的

观察维生素B1治疗重症监护病房获得性肌无力(ICU-AW)患者的临床疗效。

方法

回顾性分析2022年7月至2023年12月在同济大学附属上海东方医院重症监护病房(ICU)接受维生素B1治疗的ICU-AW患者。采用倾向得分匹配法,以1:1的比例匹配对照组和观察组,考虑患者年龄、性别以及急性生理与慢性健康状况评分系统II(APACHE II)的差异。对照组接受常规治疗,观察组在常规治疗基础上额外接受维生素B1治疗。比较两组患者的基本信息、治疗前后的APACHE II评分、医学研究委员会肌力评分(MRC)、白细胞介素-6(IL-6)、C反应蛋白(CRP)和血清肌酐(SCr)水平,收集并比较两组患者的机械通气时间和ICU住院时间。

结果

共纳入30例ICU-AW患者,每组各15例。两组患者在性别、年龄和APACHE II评分方面无显著差异。治疗前,两组患者的APACHE II评分、MRC评分、IL-6、CRP、SCr水平以及机械通气辅助时间和ICU住院时间均无显著差异。两组患者治疗后APACHE II评分和MRC评分均有所改善,观察组改善程度显著高于对照组(APACHE II评分:10.80±1.47 vs. 12.20±1.52,MRC评分:50.40±7.10 vs. 42.00±8.78,均P<0.05)。治疗后,两组患者的IL-6、CRP和SCr水平均显著降低,但观察组与对照组之间无显著差异。与对照组相比,观察组的机械通气时间(天数:7.67±1.54 vs. 9.67±2.44,P<0.05)和ICU住院时间(天数:13.33±1.72 vs. 15.13±2.56,P<0.05)显著缩短。

结论

在ICU-AW治疗期间使用维生素B1可显著提高肌力,缩短机械通气时间和ICU住院时间。

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