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Systematic Review Article

糖皮质激素给药在心脏骤停患者中的疗效：临床研究的系统综述

卷 29, 期 1, 2022

发表于: 31 May, 2021

页: [136 - 151] 页: 16

弟呕挨: 10.2174/0929867328666210531145617

价格: $65

摘要

背景：心脏骤停 （CA） 的病理生理学包括全身炎症反应过度激活、相对肾上腺皮质功能不全和糖萼损伤。皮质类固醇在防止内皮糖萼的干扰方面具有有益作用。目的：本系统评价的目的是确定糖皮质激素对心脏骤停患者的疗效。 方法：在2019年9月之前，我们检索了PubMed、Scopus、ISI Web of Science、Google Scholar和Cochrane中央注册库，以进行相关的临床试验和队列研究。 结果：我们检索了7项同行评审的已发表研究，用于系统评价。两项研究是评估147名患者的临床试验，而五项研究则说明了队列设计，评估了196，192名患者。总共评估了196，339名患者。有限的证据和相互矛盾的结果证实了糖皮质激素与心脏骤停患者生存之间的相关性。然而，在观察性研究中，这些药物与入院生存率、出院生存率和1年生存率之间的联系是强烈且一致的。 结论：关于糖皮质激素在CA中的疗效和安全性的临床证据仅限于方法不一致的观察性研究，以及样本量小的临床试验很少。然而，在心肺复苏 （CPR） 期间和之后补充糖皮质激素似乎在入院生存、出院生存、1 年生存率和提高自发循环 （ROSC） 率方面可能具有有益效果，特别是在血流动力学不稳定和心血管疾病（即难治性血流动力学休克）患者中。未来需要进行高质量、大规模、长期干预和精确基线特征的研究，以评估糖皮质激素在 CA 中的确切有效剂量、持续时间和疗效。

关键词: 心脏骤停，糖皮质激素，糖隼脱落，复苏后综合征，自发循环恢复，生存。

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