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首页> 外文期刊>Heart failure reviews >Patients with high-dose diuretics should get ultrafiltration in the management of decompensated heart failure: a meta-analysis
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Patients with high-dose diuretics should get ultrafiltration in the management of decompensated heart failure: a meta-analysis

机译：高剂量利尿剂的患者应在失代偿性心力衰竭管理中获得超滤：META分析

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摘要

The identification of specific patients with decompensated heart failure (DHF) who may benefit from ultrafiltration (UF) is important in clinical practice. We undertook a meta-analysis to compare the effects of ultrafiltration and diuretics on major clinical outcomes. The outcomes included weight change, length of hospital stay, rehospitalization for HF, mortality, change in serum creatinine, dialysis dependence, and adverse outcomes. We identified 14 trials including 975 patients with HF, met the eligibility criteria. There was a reduction in heart failure-related rehospitalization in ultrafiltration group when compared with the diuretic group. Subgroup analyses revealed a trend toward the decreased HF readmissions in ultrafiltration plus diuretic therapy group but did not reach statistical significance compared with ultrafiltration alone therapy. Overall, UF treatment did not produce apparent beneficial effects for weight loss, lengths of hospitalization, total mortality, the change of serum creatinine, and dialysis rate. Subgroup analyses showed increase in the serum creatinine were significantly higher for a higher dose regimen (> 200 mg/day) when compared with lower dose diuretic therapy (< 200 mg/day). As for adverse events, UF patients were associated with an increased risk of hypotension and lower risk of neurologic symptoms. The current results revealed ultrafiltration was associated with significant reduction in the rate of rehospitalization. Increase in the serum creatinine was observed in patients with high-dose diuretic regimen. Patients with high-dose diuretics should get ultrafiltration therapy.
机译：在临床实践中鉴定可能受益于超滤（UF）的失代偿性心力衰竭（DHF）的特异性患者在临床实践中是重要的。我们进行了荟萃分析，以比较超滤和利尿剂对主要临床结果的影响。结果包括重量变化，住院时间长，HF的再生，死亡率，血清肌酐的变化，透析依赖性和不良结果。我们确定了14项试验，其中包括975名患者，达到了资格标准。与利尿基团相比，超滤组心力衰竭相关的再生生殖器有降低。亚组分析揭示了超滤育加利尿管疗法中减少的HF入伍的趋势，但与单独的超滤相比，没有达到统计学显着性。总体而言，UF治疗对体重减轻，住院长度，总死亡率，血清肌酐的变化以及透析率的性能没有产生明显的有益效果。与较低剂量利尿疗法（<200mg /天）相比，亚组分析显示血清肌酐的增加对于更高剂量的方案（> 200mg /天）显着更高。至于不良事件，UF患者与低血压风险增加和神经系统症状的风险增加有关。目前的结果揭示了超滤与再生的重量显着降低有关。在高剂量利尿方案患者中观察到血清肌酐的增加。高剂量利尿剂的患者应该得到超滤治疗。

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