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Chest:特发性肺纤维化患者胃食管反流治疗!

2018-03-18 xing.T MedSci原创

由此可见,低质量的证据表明GER药物治疗与IPF相关的死亡率降低有关,但与总死亡率无关。在IPF患者进行抗酸治疗需要随机试验进行验证。

胃食管返流(GER)在特发性肺纤维化(IPF)患者中较为常见,被认为是导致疾病进展和恶化的潜在因素。治疗GER是否可以改善IPF患者的健康结局存在争议。近日,呼吸领域权威杂志chest上发表了一篇荟萃分析文章,研究人员的目的是评估IPF患者接受GER治疗的有效性和安全性。

研究人员进行了一项系统回顾和荟萃分析,通过检索MEDLINE、EMBASE、CENTRAL 和Clinicaltrials.gov等数据库,检索时间从数据库成立至2017年9月,同时检索了谷歌学术和会议摘要,查找了评价药物或非药物GER治疗效应的没有语言限制的随机和观察性研究。主要结局为IPF相关的死亡率和全因死亡率。根据GRADE法评估了证据等级。

研究人员通过检索策略确定了十三项观察性研究,8项研究纳入了Meta分析。GER治疗药物与IPF相关死亡率降低显著相关,与无GER治疗的患者相比(未经调整的风险,HR为0.60,95%CI为0.38-0.97,P = 0.04,I2 = 0%,3项研究,n = 2033;调整后的风险,HR为0.45,95%CI为0.24-0.84,P = 0.01,I2 = 0%,3项研究,n = 2033),但全因死亡率不存在这种关系(未经调整的HR为0.73,95%CI为0.45-1.2,P = 0.22,I2 = 46%,3项研究,n = 1316;3研究,调整后的HR为0.76,95% CI 0.31-1.84,P = 0.54,I2 = 89%,4项研究,n = 1585)。这些结果的证据质量很低。

由此可见,低质量的证据表明GER药物治疗与IPF相关的死亡率降低有关,但与总死亡率无关。在IPF患者进行抗酸治疗需要随机试验进行验证。

原始出处:


Lee Fidler,et al. Treatment of Gastroesophageal Reflux in Patients with Idiopathic Pulmonary Fibrosis: a Systematic Review and Meta-Analysis.chest.2018. https://doi.org/10.1016/j.chest.2018.03.008

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    2018-06-13 Smile2680
  3. 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time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297491, encodeId=aa5829e491a7, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 18 22:28:24 CST 2018, time=2018-03-18, status=1, ipAttribution=)]
    2018-03-25 大爰

    学习并分享!!

    0

  6. 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CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571615, encodeId=0fa515e161502, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Tue Mar 20 07:55:00 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297621, encodeId=5bc329e62107, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Mar 19 07:10:31 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297491, encodeId=aa5829e491a7, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 18 22:28:24 CST 2018, time=2018-03-18, status=1, ipAttribution=)]
    2018-03-20 zhouqu_8
  8. [GetPortalCommentsPageByObjectIdResponse(id=1894659, encodeId=853f18946591a, content=<a href='/topic/show?id=e45b6e859f3' target=_blank style='color:#2F92EE;'>#特发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67859, encryptionId=e45b6e859f3, topicName=特发性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Fri Jun 01 23:55:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929479, encodeId=327819294e944, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, 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time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297491, encodeId=aa5829e491a7, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 18 22:28:24 CST 2018, time=2018-03-18, status=1, ipAttribution=)]
    2018-03-20 feifers
  9. 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CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571615, encodeId=0fa515e161502, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Tue Mar 20 07:55:00 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297621, encodeId=5bc329e62107, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Mar 19 07:10:31 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297491, encodeId=aa5829e491a7, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 18 22:28:24 CST 2018, time=2018-03-18, status=1, ipAttribution=)]
    2018-03-19 owlhealth

    不错耶.学习了

    0

  10. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83405, encryptionId=2f71834056f, topicName=胃食管反流)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Tue Mar 20 07:55:00 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437307, encodeId=50d6143e30773, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Mar 20 07:55:00 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571615, encodeId=0fa515e161502, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Tue Mar 20 07:55:00 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297621, encodeId=5bc329e62107, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Mar 19 07:10:31 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297491, encodeId=aa5829e491a7, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Mar 18 22:28:24 CST 2018, time=2018-03-18, status=1, ipAttribution=)]
    2018-03-18 惠映实验室

    学习了.谢谢分享.

    0

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