Chronic

慢性
  • 文章类型: Journal Article
    背景:互联网技术的发展大大提高了慢性阻塞性肺疾病(COPD)患者获取健康信息的能力,在患者-医生决策过程中给予患者更多的主动性。然而,对网站健康信息质量的担忧会影响患者网站搜索行为的积极性。因此,有必要对我国COPD网络信息现状进行评价。
    目的:本研究旨在评估中国互联网上COPD治疗信息的质量。
    方法:使用标准疾病名称\"\"(\"慢性阻塞性肺疾病\"中文)和常用的公共检索词\"\"(\"COPD\")和\"\"(\"肺气肿\")结合关键词\"\"(\"治疗\"),我们搜索了百度的PC客户端网页,搜狗,和360搜索引擎,并于2021年7月至8月筛选了该网站的前50个链接。所有网站的语言仅限于中文。DISCERN工具用于评估网站。
    结果:共纳入96个网站并进行分析。所有网站的平均总体DISCERN评分为30.4(SD10.3;范围17.3-58.7;低质量),没有一个网站达到DISCERN的最高评分75分,每个项目的平均评分为2.0分(SD0.7;范围1.2-3.9).术语之间的平均DISCERN得分存在显着差异,“慢性阻塞性肺疾病”的平均得分最高。
    结论:中国互联网上的COPD信息质量较差,主要表现在COPD治疗信息的可靠性和相关性较低,这很容易导致消费者做出不恰当的治疗选择。术语“慢性阻塞性肺疾病”在常用疾病搜索词中具有最高的DISCERN评分。建议消费者在搜索网站信息时使用标准疾病名称,因为获得的信息相对可靠。
    BACKGROUND: The development of internet technology has greatly increased the ability of patients with chronic obstructive pulmonary disease (COPD) to obtain health information, giving patients more initiative in the patient-physician decision-making process. However, concerns about the quality of website health information will affect the enthusiasm of patients\' website search behavior. Therefore, it is necessary to evaluate the current situation of Chinese internet information on COPD.
    OBJECTIVE: This study aims to evaluate the quality of COPD treatment information on the Chinese internet.
    METHODS: Using the standard disease name \"\" (\"chronic obstructive pulmonary disease\" in Chinese) and the commonly used public search terms \"\" (\"COPD\") and \"\" (\"emphysema\") combined with the keyword \"\" (\"treatment\"), we searched the PC client web page of Baidu, Sogou, and 360 search engines and screened the first 50 links of the website from July to August 2021. The language was restricted to Chinese for all the websites. The DISCERN tool was used to evaluate the websites.
    RESULTS: A total of 96 websites were included and analyzed. The mean overall DISCERN score for all websites was 30.4 (SD 10.3; range 17.3-58.7; low quality), no website reached the maximum DISCERN score of 75, and the mean score for each item was 2.0 (SD 0.7; range 1.2-3.9). There were significant differences in mean DISCERN scores between terms, with \"chronic obstructive pulmonary disease\" having the highest mean score.
    CONCLUSIONS: The quality of COPD information on the Chinese internet is poor, which is mainly reflected in the low reliability and relevance of COPD treatment information, which can easily lead consumers to make inappropriate treatment choices. The term \"chronic obstructive pulmonary disease\" has the highest DISCERN score among commonly used disease search terms. It is recommended that consumers use standard disease names when searching for website information, as the information obtained is relatively reliable.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    本研究的目的是揭示急性和慢性热应激(HS)对瘤胃微生物组的丰度和功能以及宿主代谢的影响。
    将40只泌乳中期山羊随机分为两个人工环境,对照组和热应激组。这项研究是从两个时期收集的,1天和28天。第一天定义为对照1(CT1)和HS1(急性HS),最后一天定义为CT28和HS28(慢性HS)。在第一天和最后一天,随机抽取每组6只奶山羊,于早晨经口胃管饲喂后收集瘤胃液。每天记录谷仓温度和湿度。
    在慢性HS下观察到瘤胃微生物组的破坏,以普雷沃氏菌和拟杆菌的丰度增加(p<0.05)为代表,以及碳水化合物运输和代谢功能的上调(p<0.05)。此外,慢性HS中的丁香单胞菌和反刍动物的丰度低于急性HS(p<0.05),细胞内贩运的功能,分泌和囊泡运输,细胞骨架下调(p<0.05)。
    HS影响了微生物群与宿主之间的相互作用,从而调节奶山羊的产奶量。这些发现增加了对宿主和微生物之间串扰的理解。
    UNASSIGNED: The objective of this study was to reveal the influence of acute and chronic heat stress (HS) on the abundance and function of rumen microbiome and host metabolism.
    UNASSIGNED: The forty mid-lactation goats were randomly divided into two artificial environments a control group and a heat-stressed group. This study was collected from two periods, 1 day and 28 days. The first day was defined as control 1 (CT1) and HS 1 (acute HS), and the last day was defined as CT28 and HS28 (chronic HS). On the first and last day, 6 dairy goats in each group were randomly selected to collect rumen liquid after the morning feeding through oral stomach tubes. The barn temperature and humidity were recorded every day.
    UNASSIGNED: Disruption of the rumen microbiome was observed under chronic HS, represented by an increase in the abundance of Prevotella and Bacteroidales (p<0.05), and upregulation of carbohydrate transport and metabolism functions (p<0.05). Additionally, the abundance of Succinimonas and Ruminobacter in chronic HS is lower than in acute HS (p<0.05), and the functions of intracellular trafficking, secretion and vesicular transport, and the cytoskeleton were downregulated (p<0.05).
    UNASSIGNED: HS affected the interaction between the microbiota and host, thereby regulating milk production in dairy goats. These findings increased understanding of the crosstalk between hosts and microorganisms.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Letter
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    T-2毒素是毒性最强的真菌毒素之一。人们主要通过食用变质的食物接触T-2毒素,通常是长时间和低剂量。T-2毒素可引起关节软骨损伤。然而,确切的机制还不完全清楚。在这个实验中,36只雄性大鼠分为对照组,溶剂对照组,和T-2毒素组。T-2毒素组的大鼠以100ng/gBW/天的剂量口服施用毒素。在4、8、12和16周评估关节软骨和与自噬过程和HIF-1α/AMPK信号轴相关的关键蛋白的损伤。我们的发现表明,T-2毒素诱导的大鼠关节软骨损伤与HIF-1α/AMPK信号通路相关的自噬受损同时发生。这项研究为T-2毒素诱导的关节软骨损伤的精确机制提供了新的见解。
    T-2 toxin is one of the most toxic mycotoxins. People are primarily exposed to T-2 toxin through the consumption of spoiled food, typically over extended periods and at low doses. T-2 toxin can cause damage to articular cartilage. However, the exact mechanism is not fully understood. In this experiment, 36 male rats were divided into a control group, a solvent control group, and a T-2 toxin group. The rats in the T-2 toxin group were orally administered the toxin at a dosage of 100 ng/g BW/Day. The damage to articular cartilage and key proteins associated with the autophagy process and the HIF-1α/AMPK signaling axis was assessed at 4, 8, 12, and 16 weeks. Our findings indicate that T-2 toxin-induced damage to articular cartilage in rats coincided with impaired autophagy linked to the HIF-1α/AMPK signaling pathway. This study offers novel insights into the precise mechanism underlying T-2 toxin-induced damage to articular cartilage.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:颈部疼痛是导致颈部运动功能障碍和随后的残疾的常见病,带来了巨大的全球医疗保健负担。作为一种新兴的工具,虚拟现实(VR)技术已被用来解决疼痛和减少颈部疼痛患者的残疾。然而,目前还缺乏高质量的研究来评价VR疗法联合常规康复治疗对慢性颈痛患者的疗效,特别是在运动学功能方面。
    目的:本研究旨在探讨VR疗法联合常规康复治疗对疼痛的影响。运动学功能,慢性颈部疼痛患者的残疾。
    方法:我们进行了评估盲法,隐藏分配的随机对照试验。64名经历慢性颈部疼痛的参与者被随机分配到接受VR康复加常规康复的实验组或接受相同量的常规康复的对照组,为期4周,共10次。疼痛强度,残疾,运动学功能(颈椎活动范围,本体感受,以及平均和峰值速度),满意度,并在3个时间点评估症状缓解情况(基线,干预后,和3个月的随访)。2*3混合重复测量方差分析用于分析各指标的差异,与0.05的显著差异水平。
    结果:两组均显示疼痛有显著改善,残疾,干预后和3个月随访时的运动学功能(P<0.05)。与对照组相比,实验组在疼痛减轻方面表现出更好的治疗效果(与基线的平均差异:治疗后5.50vs1.81;3个月随访时5.21vs1.91,分别;P<.001),残疾改善(与基线的平均差:治疗后3.04vs0.50;3个月随访时3.20vs0.85,分别;P<.001),和增强的运动学功能(P<0.05)。此外,实验组的参与者报告的满意度和症状缓解优于对照组(P<0.05),在随访期间锻炼的主动性更好。然而,本体感觉改善无组间差异.在我们的研究中没有报告或观察到不良事件。
    结论:我们的研究结果支持VR疗法与常规康复相结合减轻疼痛的疗效,增强运动学功能,减少慢性颈痛患者的残疾。未来的研究应该集中在完善VR治疗的治疗方案和剂量,以及优化其在临床环境中的应用,以提高便利性和有效性。
    背景:中国临床试验注册ChiCTR2000040132;http://www.chictr.org.cn/showproj.aspx?proj=64346。
    BACKGROUND: Neck pain is a common condition that leads to neck motor dysfunction and subsequent disability, with a significant global health care burden. As a newly emerging tool, virtual reality (VR) technology has been employed to address pain and reduce disability among patients with neck pain. However, there is still a lack of high-quality studies evaluating the efficacy of VR therapy combined with conventional rehabilitation for patients with chronic neck pain, particularly in terms of kinematic function.
    OBJECTIVE: This study aims to investigate the effect of VR therapy combined with conventional rehabilitation on pain, kinematic function, and disability in patients with chronic neck pain.
    METHODS: We conducted an assessor-blinded, allocation-concealed randomized controlled trial. Sixty-four participants experiencing chronic neck pain were randomly allocated into the experimental group that underwent VR rehabilitation plus conventional rehabilitation or the control group receiving the same amount of conventional rehabilitation alone for 10 sessions over 4 weeks. Pain intensity, disability, kinematic function (cervical range of motion, proprioception, and mean and peak velocity), degree of satisfaction, and relief of symptoms were evaluated at 3 timepoints (baseline, postintervention, and at 3 months follow-up). A 2*3 mixed repeated measures analysis of variance was utilized for analyzing the difference across indicators, with a significant difference level of .05.
    RESULTS: Both groups demonstrated significant improvements in pain, disability, and kinematic functions (P<.05) at postintervention and at 3-month follow-up. The experimental group showed superior therapeutic outcomes compared to the control group in pain reduction (mean difference from the baseline: 5.50 vs 1.81 at posttreatment; 5.21 vs 1.91 at the 3-month follow-up, respectively; P<.001), disability improvement (mean difference from baseline: 3.04 vs 0.50 at posttreatment; 3.20 vs 0.85 at the 3-month follow-up, respectively; P<.001), and enhanced kinematic functions (P<.05). Moreover, participants in the experimental group reported better satisfaction and relief of symptoms than the control group (P<.05), with better initiative for exercising during the follow-up period. However, there was no between-group difference of improvement in proprioception. No adverse events were reported or observed in our research.
    CONCLUSIONS: The findings of our study support the efficacy of combining VR therapy with conventional rehabilitation in alleviating pain, enhancing kinematic function, and reducing disability of patients with chronic neck pain. Future research should focus on refining the therapeutic protocols and dosages for VR therapy as well as on optimizing its application in clinical settings for improved convenience and effectiveness.
    BACKGROUND: Chinese Clinical Trial Registry ChiCTR2000040132; http://www.chictr.org.cn/showproj.aspx?proj=64346.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:评估定量磁共振(MR)成像生物标志物在区分炎性胰腺肿块(IPM)和胰腺癌(PC)中的诊断性能。
    方法:使用PubMed进行了文献检索,Embase,Cochrane图书馆,和WebofScience到2023年8月。诊断准确性研究2(QUADAS-2)的质量评估用于评估研究的偏倚风险和适用性。汇集的敏感性,特异性,正似然比,负似然比,和诊断比值比使用DerSimonian-Laird方法计算。使用单因素荟萃回归分析来确定异质性的潜在因素。
    结果:本荟萃分析包括24项研究。IPM的两种主要类型,肿块型胰腺炎(MFP)和自身免疫性胰腺炎(AIP),它们的表观扩散系数(ADC)值不同。与PC相比,MFP的ADC值较高,但AIP值较低。ADC的合并敏感性/特异性为0.80/0.85用于区分MFP和PC和0.82/0.84用于区分AIP和PC。上游主胰管最大直径(dMPD)的合并敏感性/特异性为0.86/0.74,截止dMPD≤4mm,和0.97/0.52,截止dMPD≤5mm。灌注分数(f)的合并敏感性/特异性为0.82/0.68,质量刚度值为0.82/0.77。
    结论:定量MR成像生物标志物可用于区分IPM和PC。MFP和AIP之间的ADC值不同,他们应该分开考虑在未来的研究。
    结论:定量MR参数可作为非侵入性成像生物标志物,用于区分恶性胰腺肿瘤和胰腺炎性肿块,因此有助于避免不必要的手术。
    结论:•几种定量MR成像生物标志物在炎性胰腺肿块和胰腺癌的鉴别诊断中表现良好。•ADC值可以辨别胰腺癌与肿块型胰腺炎或自身免疫性胰腺炎,如果两种炎性肿块类型没有合并。•主胰管的直径对于区分自身免疫性胰腺炎和胰腺癌具有最高的特异性。
    OBJECTIVE: To evaluate the diagnostic performance of quantitative magnetic resonance (MR) imaging biomarkers in distinguishing between inflammatory pancreatic masses (IPM) and pancreatic cancer (PC).
    METHODS: A literature search was conducted using PubMed, Embase, the Cochrane Library, and Web of Science through August 2023. Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was used to evaluate the risk of bias and applicability of the studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were calculated using the DerSimonian-Laird method. Univariate meta-regression analysis was used to identify the potential factors of heterogeneity.
    RESULTS: Twenty-four studies were included in this meta-analysis. The two main types of IPM, mass-forming pancreatitis (MFP) and autoimmune pancreatitis (AIP), differ in their apparent diffusion coefficient (ADC) values. Compared with PC, the ADC value was higher in MFP but lower in AIP. The pooled sensitivity/specificity of ADC were 0.80/0.85 for distinguishing MFP from PC and 0.82/0.84 for distinguishing AIP from PC. The pooled sensitivity/specificity for the maximal diameter of the upstream main pancreatic duct (dMPD) was 0.86/0.74, with a cutoff of dMPD ≤ 4 mm, and 0.97/0.52, with a cutoff of dMPD ≤ 5 mm. The pooled sensitivity/specificity for perfusion fraction (f) was 0.82/0.68, and 0.82/0.77 for mass stiffness values.
    CONCLUSIONS: Quantitative MR imaging biomarkers are useful in distinguishing between IPM and PC. ADC values differ between MFP and AIP, and they should be separated for consideration in future studies.
    CONCLUSIONS: Quantitative MR parameters could serve as non-invasive imaging biomarkers for differentiating malignant pancreatic neoplasms from inflammatory masses of the pancreas, and hence help to avoid unnecessary surgery.
    CONCLUSIONS: • Several quantitative MR imaging biomarkers performed well in differential diagnosis between inflammatory pancreatic mass and pancreatic cancer. • The ADC value could discern pancreatic cancer from mass-forming pancreatitis or autoimmune pancreatitis, if the two inflammatory mass types are not combined. • The diameter of main pancreatic duct had the highest specificity for differentiating autoimmune pancreatitis from pancreatic cancer.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    脊髓型颈椎病(CSM),全球脊髓功能障碍最常见的原因,是一种导致非暴力的退行性疾病,渐进的,和颈脊髓的长期压迫。这项研究的目的是研究微血管增殖是否可以积极影响实验性脊髓型颈椎病(CSM)的神经功能恢复。
    将60名成年雄性Sprague-Dawley(SD)随机分为四组:对照组(CON),压缩(COM),血管停滞(AS),和血管生成(AG),每组15只大鼠。AS组大鼠接受SU5416抑制血管生成,AG组大鼠接受去铁胺(DFO)促进血管生成。使用BassoBeattieBresnahan(BBB)量表和体感诱发电位(SEP)检查评估运动和感觉功能。通过神经元的数量来评估神经病理学变性,Nissl体(NB),苏木精和伊红(HE)检测到白质的去髓鞘化,甲苯胺蓝(TB),和Luxol固蓝(LFB)染色。免疫组织化学(IHC)染色用于观察神经血管单元(NVU)。
    CON组的大鼠表现出正常的运动功能,具有完整的BBB评分,正常的SEP潜伏期和振幅。在其他三组中,AG组BBB评分最高,SEP潜伏期最短,AS组BBB评分最低,SEP潜伏期最长。SEP幅度显示出与延迟相反的性能。与COM和AS组相比,AG组表现出明显的灰质神经元恢复和白质轴突髓鞘再生。DFO促进微血管增殖,尤其是在灰质中,并提高了神经胶质细胞的存活率。相比之下,SU-5416通过减少微血管抑制神经胶质细胞的活力。
    微血管状态与NVU重塑和功能恢复密切相关。因此,微血管的增殖有助于实验性CSM的功能恢复,这可能与NVU重塑相关联。
    UNASSIGNED: Cervical Spondylotic Myelopathy (CSM), the most common cause of spinal cord dysfunction globally, is a degenerative disease that results in non-violent, gradual, and long-lasting compression of the cervical spinal cord. The objective of this study was to investigate whether microvascular proliferation could positively affect neural function recovery in experimental cervical spondylotic myelopathy (CSM).
    UNASSIGNED: A total of 60 male adult Sprague-Dawley (SD) were randomly divided into four groups: Control (CON), Compression (COM), Angiostasis (AS), and Angiogenesis (A G),with 15 rats in each group. Rats in the AS group received SU5416 to inhibit angiogenesis, while rats in the AG group received Deferoxamine (DFO) to promote angiogenesis. Motor and sensory functions were assessed using the Basso Beattie Bresnahan (BBB) scale and somatosensory evoked potential (SEP) examination. Neuropathological degeneration was evaluated by the number of neurons, Nissl bodies (NB), and the de-myelination of white matter detected by Hematoxylin & Eosin(HE), Toluidine Blue (TB), and Luxol Fast Blue (LFB) staining. Immunohistochemical (IHC) staining was used to observe the Neurovascular Unit (NVU).
    UNASSIGNED: Rats in the CON group exhibited normal locomotor function with full BBB score, normal SEP latency and amplitude. Among the other three groups, the AG group had the highest BBB score and the shortest SEP latency, while the AS group had the lowest BBB score and the most prolonged SEP latency. The SEP amplitude showed an opposite performance to the latency. Compared to the COM and AS groups, the AG group demonstrated significant neuronal restoration in gray matter and axonal remyelination in white matter. DFO promoted microvascular proliferation, especially in gray matter, and improved the survival of neuroglial cells. In contrast, SU-5416 inhibited the viability of neuroglial cells by reducing micro vessels.
    UNASSIGNED: The microvascular status was closely related to NVU remodeling an-d functional recovery. Therefore, proliferation of micro vessels contributed to function -al recovery in experimental CSM, which may be associated with NVU remodeling.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Meta-Analysis
    背景:下腰痛是全球最普遍的疼痛之一。基于虚拟现实的训练已被用于下腰痛作为一种新的治疗策略。目前的证据表明,基于虚拟现实的训练对慢性腰背痛患者的有效性尚无定论。
    目的:这项研究进行了一项荟萃分析,以评估基于虚拟现实的训练对疼痛的即时和短期影响,疼痛相关的恐惧,慢性腰痛患者的残疾。
    方法:我们搜索了PubMed,Embase,WebofScience,PEDro,中部,和CINAHL数据库从成立到2024年1月。仅选择了评估基于虚拟现实的训练对慢性下腰痛患者的影响的随机对照试验。结果集中在疼痛上,通过运动恐惧症的坦帕量表测量与疼痛相关的恐惧,和Oswestry残疾指数衡量的残疾。近期期限定义为干预后的近期期限,短期定义为干预后3~6个月.偏差工具的Cochrane风险和等级(建议分级,评估,开发和评估)方法用于评估方法和证据的质量,分别。
    结果:总计,20项涉及1059例患者的随机对照试验符合分析条件。基于虚拟现实的训练显示疼痛有显著改善(平均差异[MD]-1.43;95%CI-1.86至-1.00;I2=95%;P<.001),使用坦帕运动恐惧症量表(MD-5.46;95%CI-9.40至1.52;I2=90%;P=.007),使用Oswestry残疾指数(MD-11.50;95%CI-20.00至-3.01;I2=95%;P=.008)对干预后立即患有慢性下腰痛的个体进行残疾。然而,在疼痛方面没有观察到显著差异(P=.16),疼痛相关的恐惧(P=0.10),和残疾(P=0.43)在短期内。
    结论:这些发现表明,基于虚拟现实的训练可以有效地用于近期患有慢性下腰痛的个体,尤其是减轻疼痛,减轻疼痛相关的恐惧,改善残疾。然而,短期获益需要更多高质量试验来证明.
    背景:PROSPEROCRD42021292633;http://tinyurl.com/25mydxpz。
    BACKGROUND: Low back pain is one of the most prevalent pain conditions worldwide. Virtual reality-based training has been used for low back pain as a new treatment strategy. Present evidence indicated that the effectiveness of virtual reality-based training for people with chronic low back pain is inconclusive.
    OBJECTIVE: This study conducted a meta-analysis to evaluate the immediate- and short-term effects of virtual reality-based training on pain, pain-related fear, and disability in people with chronic low back pain.
    METHODS: We searched the PubMed, Embase, Web of Science, PEDro, CENTRAL, and CINAHL databases from inception until January 2024. Only randomized controlled trials assessing the effects of virtual reality-based training on individuals with chronic low back pain were selected. The outcomes were focused on pain, pain-related fear measured by the Tampa Scale of Kinesiophobia, and disability measured by the Oswestry Disability Index. The immediate term was defined as the immediate period after intervention, and the short term was defined as 3 to 6 months after intervention. The Cochrane Risk of Bias tool and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach were used to evaluate the quality of the methodology and evidence, respectively.
    RESULTS: In total, 20 randomized controlled trials involving 1059 patients were eligible for analysis. Virtual reality-based training showed significant improvements in pain (mean difference [MD] -1.43; 95% CI -1.86 to -1.00; I2=95%; P<.001), pain-related fear using the Tampa Scale of Kinesiophobia (MD -5.46; 95% CI -9.40 to 1.52; I2=90%; P=.007), and disability using the Oswestry Disability Index (MD -11.50; 95% CI -20.00 to -3.01; I2=95%; P=.008) in individuals with chronic low back pain immediately after interventions. However, there were no significant differences observed in pain (P=.16), pain-related fear (P=.10), and disability (P=.43) in the short term.
    CONCLUSIONS: These findings indicated that virtual reality-based training can be used effectively for individuals with chronic low back pain in the immediate term, especially to reduce pain, alleviate pain-related fear, and improve disability. However, the short-term benefits need more high-quality trials to be demonstrated.
    BACKGROUND: PROSPERO CRD42021292633; http://tinyurl.com/25mydxpz.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Meta-Analysis
    背景:众所周知,无症状性高尿酸血症和痛风在慢性肾脏病(CKD)患者中发挥重要作用。然而,降尿酸治疗(ULT)对伴有无症状高尿酸血症的CKD患者预后的影响仍存在争议.因此,我们旨在探讨ULT对这些患者肾脏结局的影响.
    方法:在PubMed,EMBASE,中国国民知识互联网(CNKI),还有Cochrane图书馆,直到2024年1月。我们纳入了随机对照试验(RCT),评估了ULT对无症状高尿酸血症CKD患者肾脏结局的影响。
    结果:共有17项研究纳入荟萃分析。与安慰剂或不治疗相比,ULT保留了长期亚组的估计肾小球滤过率(eGFR)的损失(加权平均差[WMD]及其95%置信区间(CI):2.07[0.15,3.98]mL/min/1.73m2)。同时,短期亚组也证明了eGFR的保留损失(WMD5.74[2.09,9.39]mL/min/1.73m2)。与安慰剂或不治疗相比,ULT还降低了短期(WMD-44.48[-84.03,-4.92]μmol/L)亚组和长期(WMD-46.13[-65.64,-26.62]μmol/L)亚组的血清肌酐(Scr)升高。ULT与无透析时Scr加倍事件的发生率较低相关(相对风险(RR)0.32[0.21,0.49],p<0.001)。然而,急性肾损伤(AKI)发生率较低无差异(p=0.943).
    结论:根据我们的研究,ULT在短期到长期随访中都有利于减缓CKD进展。此外,在60岁以下的患者中,ULT对肾脏结局的保护作用更为明显。然而,AKI的发生率无显著差异。这些发现强调了在无症状高尿酸血症的CKD患者的临床策略中考虑ULT的重要性。
    BACKGROUND: It is well known that asymptomatic hyperuricemia and gout play an important role in patients with chronic kidney disease (CKD). However, the effect of uric acid-lowering therapy (ULT) on the prognosis of CKD patients with asymptomatic hyperuricemia remains controversial. Therefore, we aim to investigate the influence of ULT on renal outcomes in these patients.
    METHODS: Comprehensive searches were conducted in PubMed, EMBASE, China National Knowledge Internet (CNKI), and the Cochrane Library, up until January 2024. We included randomized controlled trials (RCTs) that evaluated the effects of ULT on renal outcomes in CKD patients with asymptomatic hyperuricemia.
    RESULTS: A total of 17 studies were included in the meta-analysis. Compared with placebo or no treatment, ULT preserved the loss of estimated glomerular filtrating rate (eGFR) (Weighted mean difference [WMD] and its 95% confidence intercal(CI): 2.07 [0.15,3.98] mL/min/1.73m2) at long-term subgroup. At the same time, short-term subgroup also proved the preserved loss of eGFR (WMD 5.74[2.09, 9.39] mL/min/1.73m2). Compared with placebo or no treatment, ULT also reduced the increase in serum creatinine (Scr) at short-term (WMD -44.48[-84.03,-4.92]μmol/L) subgroup and long-term (WMD -46.13[-65.64,-26.62]μmol/L) subgroup. ULT was associated with lower incidence of the events of doubling of Scr without dialysis (relative risk (RR) 0.32 [0.21, 0.49], p < 0.001). However, no difference was found for lower incidence of acute kidney injury (AKI) (p = 0.943).
    CONCLUSIONS: According to our study, ULT is beneficial for slowing CKD progression both in short to long-term follow-ups. Additionally, in patients younger than 60 years old, the protective effect of ULT on renal outcome is more pronounced. However, it showed no significant difference in the incidence of AKI. These findings underscore the importance of considering ULT in clinical strategies for CKD patients with asymptomatic hyperuricemia.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号