RASI, renin-angiotensin system inhibitor

  • 文章类型: Journal Article
    未经证实:心脏手术后房颤(POAF)与死亡率增加相关。盐酸兰地洛尔预防冠状动脉旁路移植术和瓣膜手术后POAF的疗效已有报道。然而,很少有证据表明其在主动脉根部后预防POAF中的作用,升主动脉,主动脉弓手术.这项研究旨在确定这些主动脉手术后静脉注射兰地洛尔与POAF发生率之间的关系。
    UNASSIGNED:我们纳入了358例连续没有术前房颤的成人患者,升主动脉,2011年1月1日至2018年12月31日在我们机构进行的主动脉弓手术。通过倾向评分匹配分析(n=222)估计兰地洛尔在预防POAF中的治疗作用。主要终点是术后72小时内POAF的发生率。次要终点包括不良临床事件,如30天死亡率和症状性脑梗死。
    未经评估:该队列的中位年龄为72岁,68.5%是男性,46.4%的患者接受了术后口服或经皮β受体阻滞剂。在通过倾向评分匹配最小化患者背景差异后,兰地洛尔组POAF的发生率明显低于参照组(18.9%vs38.7%;P=0.002)。兰地洛尔的使用与降低POAF的发生率相关(比值比,0.39;95%CI,0.21至-0.72;P=.003)。次要终点无显著差异。
    UNASSIGNED:静脉注射兰地洛尔与主动脉根部后POAF的发生率较低有关,升主动脉,主动脉弓手术.
    UNASSIGNED: Postoperative atrial fibrillation (POAF) after cardiac surgery is associated with increased mortality. The efficacy of landiolol hydrochloride for POAF prevention after coronary artery bypass grafting procedure and valve surgery has been reported. However, little evidence is available on its role in POAF prevention after aortic root, ascending aorta, and aortic arch surgery. This study aimed to determine the association between intravenous landiolol and the incidence of POAF after these aortic surgeries.
    UNASSIGNED: We included 358 consecutive adult patients without preoperative atrial fibrillation who underwent aortic root, ascending aorta, and aortic arch surgery between January 1, 2011, and December 31, 2018, at our institution. The therapeutic influence of landiolol in preventing POAF was estimated by propensity score-matched analysis (n = 222). The primary end point was the incidence of POAF within 72 hours after surgery. The secondary end points included adverse clinical events such as 30-day mortality and symptomatic cerebral infarction.
    UNASSIGNED: The median age of the cohort was 72 years, 68.5% were men, and 46.4% received postoperative oral or transdermal β-blockers. After minimizing differences in patient background by propensity score matching, the incidence of POAF in the landiolol group was significantly lower than that in the reference group (18.9% vs 38.7%; P = .002). Landiolol use was associated with reduced incidence of POAF (odds ratio, 0.39; 95% CI, 0.21 to -0.72; P = .003). There were no significant differences in secondary end points.
    UNASSIGNED: Intravenous landiolol was associated with a lower incidence of POAF after aortic root, ascending aorta, and aortic arch surgery.
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  • 文章类型: Journal Article
    糖尿病肾病(DN)是糖尿病的严重并发症,是终末期肾病的主要病因,这给全世界的人类社会造成了严重的健康问题和巨大的经济负担。常规战略,如肾素-血管紧张素-醛固酮系统阻断,血糖水平控制,和减轻体重,在许多DN管理的临床实践中,可能无法获得令人满意的结果。值得注意的是,由于多目标函数,中药作为DN治疗的主要或替代疗法具有很好的临床益处。越来越多的研究强调确定中药的生物活性化合物和肾脏保护作用的分子机制。参与糖/脂代谢调节的信号通路,抗氧化,抗炎,抗纤维化,足细胞保护已被确定为重要的作用机制。在这里,在回顾临床试验结果后,我们总结了中药及其生物活性成分在治疗和管理DN中的临床疗效,系统评价,和荟萃分析,对动物和细胞实验中报道的相关潜在机制和分子靶标进行了彻底讨论。我们旨在全面了解中药对DN的保护作用。
    Diabetic nephropathy (DN) has been recognized as a severe complication of diabetes mellitus and a dominant pathogeny of end-stage kidney disease, which causes serious health problems and great financial burden to human society worldwide. Conventional strategies, such as renin-angiotensin-aldosterone system blockade, blood glucose level control, and bodyweight reduction, may not achieve satisfactory outcomes in many clinical practices for DN management. Notably, due to the multi-target function, Chinese medicine possesses promising clinical benefits as primary or alternative therapies for DN treatment. Increasing studies have emphasized identifying bioactive compounds and molecular mechanisms of reno-protective effects of Chinese medicines. Signaling pathways involved in glucose/lipid metabolism regulation, antioxidation, anti-inflammation, anti-fibrosis, and podocyte protection have been identified as crucial mechanisms of action. Herein, we summarize the clinical efficacies of Chinese medicines and their bioactive components in treating and managing DN after reviewing the results demonstrated in clinical trials, systematic reviews, and meta-analyses, with a thorough discussion on the relative underlying mechanisms and molecular targets reported in animal and cellular experiments. We aim to provide comprehensive insights into the protective effects of Chinese medicines against DN.
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