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合并急性肾损伤的危重症患者输注白蛋白后血清白蛋白水平与28 d死亡率的相关性 被引量:1
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作者 张柳攀 石晓彤 +3 位作者 李露兰 师瑞 安胜利 曾振华 《南方医科大学学报》 北大核心 2025年第5期1074-1081,共8页
目的探讨危重症急性肾损伤(AKI)患者输注人血白蛋白后不同血清白蛋白水平与28 d死亡率的关系及其对90 d死亡率、液体出入量、持续肾脏替代治疗、机械通气比例及时间等的影响。方法回顾性纳入MIMIC IV数据库(2008~2019年)5918例在ICU内... 目的探讨危重症急性肾损伤(AKI)患者输注人血白蛋白后不同血清白蛋白水平与28 d死亡率的关系及其对90 d死亡率、液体出入量、持续肾脏替代治疗、机械通气比例及时间等的影响。方法回顾性纳入MIMIC IV数据库(2008~2019年)5918例在ICU内接受白蛋白治疗的AKI患者的资料,根据输注后72 h内血清白蛋白水平将其分为低白蛋白组(LA,<30 g/L)、中等白蛋白组(MA,30~35 g/L)和高白蛋白组(HA,>35 g/L)3组,采用限制性立方样条回归及多因素Logistic回归分析白蛋白水平与死亡率的关系。另纳入南方医科大学南方医院2017年1月~2022年2月的110例脓毒症AKI患者作为外部验证队列,通过生存分析和多因素校正验证结果。结果在MIMIC训练队列中,多因素Logistic回归分析显示不同白蛋白分组与危重症AKI患者28 d死亡率无相关性(P>0.05),但限制性立方样条分析提示白蛋白水平与28 d死亡率呈非线性剂量反应关系(阈值效应:>36 g/L时风险升高)。次要终点分析显示,与LA组相比,HA组机械通气时间更短(P<0.001),但ICU住院时间延长(P<0.001)。外部验证队列中,白蛋白水平≥30 g/L与28 d死亡率降低相关(P<0.05)。结论输注人血白蛋白以提高血清白蛋白水平与AKI危重患者28 d死亡率的关系存在队列依赖性,可能受疾病类型及严重程度、输注策略及统计方法等多因素影响。 展开更多
关键词 急性肾损伤 危重症患者 白蛋白输注 血清白蛋白水平 28 d死亡率
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A Retrospective Cohort Study on the Improvement of Prognosis of Hospitalized COVID-19 Patients Using Traditional Chinese Medicine Preparations
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作者 DOU Li WANG Wei +9 位作者 YU Manshu YUAN Sicheng HU Jingyi ZHUANG Yuwen QI Minghao WANG Yuanyuan YANG Fei MENG Jiale GUO Tao WANG Xiaoxiao 《南京中医药大学学报》 北大核心 2025年第11期1585-1595,共11页
OBJECTIVE The emergence of evolving variants of Coronavirus disease 2019(COVID-19)has fostered the need for change of newer and adaptive treatments for these infections.During the COVID-19 pandemic and persists,tradit... OBJECTIVE The emergence of evolving variants of Coronavirus disease 2019(COVID-19)has fostered the need for change of newer and adaptive treatments for these infections.During the COVID-19 pandemic and persists,traditional Chinese medicine(TCM)herbs exhibit significant bioactivity and therapeutic effect.This study is aimed to evaluate the efficacy of four TCM preparations on 28-day mortality risk of patients and changes of the laboratory indicators.METHODS The retrospective cohort study included patients with COVID-19 who were admitted to the Jiangsu Province Hospital of Chinese Medicine from December 15,2022 to January 15,2023,and those died within 48 hours of admission or cannot be tracked for outcomes were excluded.The primary outcome was survival status in 28 days(death or survival)starting from the day of admission.The second outcomes were laboratory indicators,including absolute lymphocyte count,lactate dehydrogenase,creatinine,and blood urea nitrogen.Binary logistic regressions were used to estimate the effect of TCM preparations on the primary and secondary outcomes in main analysis.Meanwhile,heterogeneity and robustness of results from main analysis were assessed by subgroup analyses and multiple sensitivity analyses.RESULTS 1816 eligible patients were included in analysis dataset,including 573 patients received standard care(control group)and 1243 patients received TCM preparations(hospital preparation group).The 28-day mortality rate of hospital preparation group was lower than that of control group(4.75%vs.14.83%),and the difference was statistically significant(χ^(2)=54.666,P<0.001).The risk of 28-day mortality was 0.535 times lower in the hospital preparation group as compared with the control group(OR=0.46,95%CI:0.305-0.708,P<0.001)showed by multivariable binary logistic regressions.Subgroup analyses showed that taking TCM preparations reduced the 28-day mortality risk.Sensitivity analyses demonstrated that the results of the main analysis for primary outcomes were robust.For secondary outcomes,the risk of abnormal absolute lymphocyte counts at discharge in the hospital preparation group decreased by 0.284 times(OR=0.703,95%CI:0.515-0.961,P=0.027).CONCLUSION Compared with standard of care,taking four hospital preparations including Kanggan Heji,Feining Heji,Qishen Gubiao Keli,and Qianghuo Qushi Qingwen Heji decreased risk of 28-day mortality among hospitalized COVID-19 patients.TCM therapy achieves adequate therapeutic effects in COVID-19. 展开更多
关键词 traditional Chinese medicine preparations COVId-19 28-day mortality retrospective cohort study
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