Newly developed immobilized polymyxin B fibers improve the survival of patients with sepsis
Newly developed immobilized polymyxin B fibers improve the survival of patients with sepsis
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DOI：
10.1159/000046966
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发表时间：
2001-01-01
影响因子：
3
通讯作者：
Suzuki, H
中科院分区：
文献类型：
--
作者：
Nemoto, H;Nakamoto, H;Suzuki, H
背景。脓毒症和感染性休克仍然是发病率和死亡率的主要原因，尽管有强大的和广泛有效的抗生素。方法：一项前瞻性、开放和随机试验，研究固定化多粘菌素纤维（PMX-F）对脓毒症患者生存的影响，随访28天，直至出院（如果更早）。98例患者至少符合感染引起的全身炎症反应综合征的4项标准。根据急性生理和慢性健康评估（APACHE） II评分将患者分为三组。结果：与对照组相比，PMX-F组总生存率显著提高（41% vs. 11%） （p = 0.002）。在APACHE II评分低于20分的患者中，PMX-F治疗可改善预后（65比19%）（p = 0.01）。在APACHE II评分为20-29分的更严重脓毒症病例中，PMX-F仍保持改善预后的疗效（40比11%）（p = 0.04）。然而，PMX-F治疗并没有提高APACHE II评分大于30的患者的生存率（生存率为7比0%）（p=0.59）。结论：在脓毒症早期应用PMX-F治疗脓毒症患者是有效的，可以延长患者的生存率。然而，在严重的脓毒症中，这种疗法并不能提高生存率。版权所有(C) 2001 S. Karger AG，巴塞尔
Background. Sepsis and septic shock are still major causes of morbidity and mortality in spite of the availability of powerful and broadly active antibiotics. Methods: A prospective, open and randomized trial of the effect of immobilized polymyxin fibers (PMX-F) on the survival of patients with sepsis throughout a follow-up period of 28 days or until discharge, if earlier, was carried out. Ninety-eight patients were included who met at least 4 of the criteria for systemic inflammatory response syndrome due to infection. The patients were classified into three groups based on their Acute Physiology and Chronic Health Evaluation (APACHE) II score. Results: The overall survival rate was significantly improved by using PMX-F compared to the control group (41 vs. 11%) (p = 0.002). In patients with an APACHE II score less than 20, treatment with PMX-F was shown to improve outcome (65 vs. 19%) (p = 0.01). In cases of more severe sepsis with an APACHE II score of 20-29, PMX-F still maintained efficacy in improving outcome (40 vs. 11%) (p = 0.04). However, PMX-F treatment did not improve the survival rate in patients with an APACHE II score of greater than 30 (survival rate 7 vs. 0%) (p=0.59). Conclusion: From these results, it is concluded that treatment with PMX-F in patients with sepsis is effective and prolongs the survival rate when applied at an early stage of sepsis. However, in severe sepsis, this therapy does not improve the survival rate. Copyright (C) 2001 S. Karger AG, Basel.