他汀类药物和体外膜肺氧合装置植入后血液相容性不良事件的关系  

Relationship between statins and hemocompatibility related clinical adverse events after extra-corporeal membrane oxygenation implantation

作　　者：雷白 侯剑峰[1] 胡盛寿[1] LEI Bai;HOU Jianfeng;HU Shengshou(Department of Surgery,Fuwai Hospital,Peking Union Medical College,Beijing,100037,China)

机构地区：[1]中国医学科学院阜外心血管病医院外科,北京100037

出　　处：《中国医药导报》2021年第32期66-70,共5页China Medical Herald

基　　金：国家重点研发计划重点专项项目(2016YFC1300900)。

摘　　要：目的探索心源性休克(PCS)患者植入体外膜肺氧合装置(ECMO)术后服用他汀类药物与早期发生血液相容性相关不良事件(HRAEs)的关系。方法收集2008年2月至2016年4月中国医学科学院阜外医院280例接受ECMO植入患者的临床资料,观察患者服用他汀类药物后HRAEs的发生情况,同时记录患者基本特征、并发症和其他用药情况。采用COX比例风险比回归等方法进行他汀类药物对HRAEs的影响研究,并采用倾向性评分进行匹配后再进行分析。结果非他汀组共212例,他汀组68例,分别有40例(18.87%)和17例(25.00%)发生HRAEs。Log-rank检验发现他汀组患者更易发生HRAEs(P=0.014),他汀组出血事件的发生率高于非他汀组(P<0.05)。多因素分析发现他汀类药物可能是HRAEs发生的危险因素[HR(95%CI)=2.149(1.100~4.201),P=0.025]。利用倾向性评分进行匹配后,发现相对于未服用他汀类药物的患者,服用他汀类药物的患者更易发生HRAEs(P=0.008)。结论PCS患者植入ECMO后60 d内服用他汀类药物可能更易发生HRAEs,研究结果还需大样本研究验证。Objective To explore the relationship of hemocompatibility related clinical adverse events(HRAEs)and statin treatment after extra-corporeal membrane oxygenation(ECMO)implantation in patients with postoperative cardiac shock(PCS).Methods Clinical data of 280 patients who received ECMO implantation in Fuwai Hospital,Peking Union Medical College from February 2008 to April 2016 were collected to observe the occurrence of HRAEs after taking statins,and the basic characteristics,complications and other medication of patients were recorded.COX proportional hazard ratio regression and other methods were used to study the effect of statins on HRAEs,and propensity score was used for matching and re-analysis.Results HRAEs occurred in 40(18.87%)and 17(25.00%)patients in the non-statin group and 68 patients in the statin group,respectively.Log-rank test showed that patients taking statins were more likely to develop HRAEs(P=0.014),and the incidence of bleeding events was higher in the statin group than in the non-statin group(P<0.05).Multivariate analysis showed that statins may be a risk factor for HRAEs[HR(95%CI)=2.149(1.100-4.201),P=0.025].After matching using a propensity score,HRAEs were more common in patients taking statins than in those not taking statins(P=0.008).Conclusion PCS patients are prone to HRAEs with statins after ECMO implantation in 60 days.The results need to be verified by large sample studies.

关 键 词：体外膜肺氧合装置 血液相容性不良事件 血液相容性评分 他汀类药物 

分 类 号：R541.1[医药卫生—心血管疾病]