Weaker Response to XueBiJing Treatment in Severe Community-Acquired Pneumonia Patients With Higher Body Mass Index or Hyperglycemia: A Post Hoc Analysis of a Randomized Controlled Trial.
Weaker Response to XueBiJing Treatment in Severe Community-Acquired Pneumonia Patients With Higher Body Mass Index or Hyperglycemia: A Post Hoc Analysis of a Randomized Controlled Trial.
复制标题
DOI：
10.3389/fphar.2022.755536
复制
发表时间：
2022
影响因子：
5.6
通讯作者：
中科院分区：
文献类型：
--
作者：
背景：超重和高血糖可能导致重症社区获得性肺炎(SCAP)患者预后不良。血必净治疗能明显改善SCAP患者的预后。观察血必净注射液对体重指数(BMI)和空腹血糖(FBG)分层治疗慢性阻塞性肺疾病(SCAP)的疗效。方法：这是一项在中国的33家医院进行的前瞻性、随机、对照的大型研究。我们比较了非超重(体重指数24≥/m2，n=425)与超重(BMI≥24 mg/m2，n=250)患者以及非高血糖(FBG<；7 mm ol/L，n=315)与高血糖(FBG Lt；7 mm ol/L，n=360)患者的数据，这些患者服用血必净，100mlq12小时，或视觉上无法区分的安慰剂治疗5-7天。结果：在体重指数为24 kg/m2的患者中，血必净组33例(15.3%)和安慰剂组52例(24.9%)在28天内死亡(P=0.0186)。在体重指数≥为24 kg/m2的患者中，血必净接受者的死亡率仍较低(血必净16.9%对安慰剂24.2%；p=0.2068)，但无显著统计学差异。空腹血糖组中，空腹血糖为7 mg/L/L者315例，血必净组18例(11.2%)，安慰剂组32例(20.8%)，28天内死亡(P=0.030)。在空腹血糖≥为7 mm ol/L的患者中，接受血必净治疗的患者死亡率仍较低(血必净20.2%对安慰剂27.8%；p=0.120)，但无显著统计学差异。两组在ICU的总住院时间和机械通气时间相似(p>；0.05)。结论：超重或高血糖可能会削弱血必净注射液治疗SCAP的疗效，28d死亡率显著升高。还需要更多的研究来验证我们的发现，并进一步了解潜在的机制。
Background: Overweight and hyperglycemia might result in poor prognosis in patients with severe community-acquired pneumonia (SCAP). XueBiJing treatment could significantly improve the outcomes of patients with SCAP. We investigated the efficacy of XueBiJing injection in patients with SCAP stratified by body mass index (BMI) and fasting blood glucose (FBG). Methods: This is a post hoc analysis of XueBiJing trial, a large prospective, randomized, controlled study conducted in 33 hospitals in China. We compared data from non-overweight (BMI <24 kg/m2, n = 425) vs. overweight (BMI ≥24 kg/m2, n = 250) patients as well as non-hyperglycemia (FBG <7 mmol/L, n = 315) vs. hyperglycemia (FBG ≥7 mmol/L, n = 360) patients with XueBiJing, 100 ml, q12 h, or a visually indistinguishable placebo treatment for 5–7 days. Results: Among patients with BMI <24 kg/m2 (n = 425), 33 (15.3%), XueBiJing recipients and 52 (24.9%) placebo recipients (p = 0.0186) died within 28 days. Among patients with BMI ≥24 kg/m2 (n = 250), XueBiJing recipients still had lower mortality (XueBiJing 16.9% vs. placebo 24.2%; p = 0.2068) but without significantly statistical difference. For the FBG group, patients with FBG <7 mmol/L (n = 315), 18 (11.2%) XueBiJing recipients and 32 (20.8%) placebo recipients (p = 0.030) died within 28 days. Among patients with FBG ≥7 mmol/L (n = 360), XueBiJing recipients still had lower mortality (XueBiJing 20.2% vs. placebo 27.8%; p = 0.120) but without significantly statistical difference. The total duration of the ICU stay and the duration of mechanical ventilation were similar in both groups (p > 0.05). Conclusion: Overweight or hyperglycemia might weaken the efficacy of XueBiJing injection in the treatment of SCAP as indicated by the significant elevated risk of 28-day mortality. Additional studies are needed to validate our findings and to further understand the underlying mechanisms.
登录
查看更多内容
影响因子：
105.7
作者：
Lepper, Philipp M.;Ott, Sebastian;Rohde, Gernot
通讯作者：
Rohde, Gernot
影响因子：
9.6
作者：
Falguera, K;Pifarre, R;Moreno, A
通讯作者：
Moreno, A
影响因子：
9.6
作者：
Jones, Richard L.;Nzekwu, Mary-Magdalene U.
通讯作者：
Nzekwu, Mary-Magdalene U.
DOI：
10.1111/j.1469-0691.2012.04003.x
发表时间：
2013-08
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Kahlon S;Eurich DT;Padwal RS;Malhotra A;Minhas-Sandhu JK;Marrie TJ;Majumdar SR
通讯作者：
Majumdar SR
血必净注射液通过减少中暑大鼠氧化应激和促炎性损伤减轻肺损伤
影响因子：
2.7
作者：
Chen Y;Tong H;Pan Z;Jiang D;Zhang X;Qiu J;Su L;Zhang M
通讯作者：
Zhang M