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JAHA:心血管疾病患者的螯合疗法

2022-03-02 MedSci原创 MedSci原创

重复使用EDTA治疗CVD可为糖尿病和严重外周动脉疾病患者带来更多益处。给药方案之间的差异,包括剂量、溶液成分和输液次数,限制了研究之间的比较。需要进一步的研究来证实这些结果并评估金属的潜在介导作用。

EDTA是一种静脉内螯合剂,对二价阳离子(例如铅、镉和钙)具有较高的亲和力,这一特性提示EDTA可能对治疗心血管疾病(CVD)具有益处。尽管一项大型随机临床试验已经展示EDTA具有CVD益处,但较小型的研究结果并不一致。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员对已发表的研究进行了一项系统评价,以评估重复使用EDTA治疗对CVD成年患者临床结局的影响。

研究人员检索了3个数据库(MEDLINE、Embase和Cochrane),检索时间从数据库创建到2021年10月,以确定所有涉及EDTA治疗心血管疾病患者的研究。该荟萃分析预先确定的结局包括死亡率、疾病严重程度、疾病慢性化的血浆生物标志物和生活质量

24项研究(4项随机临床试验、15项前瞻性研究和5项回顾性病例系列)评估了在既往CVD患者中重复使用EDTA螯合治疗的效果。其中,17项研究(1项随机临床试验)发现EDTA治疗后各自的结局均有所改善。在糖尿病和/或严重闭塞性动脉疾病患者较高患病率的研究中,研究人员观察到了最大程度的改善。研究人员对4项报告踝肱指数的研究进行的荟萃分析表明,与基线相比,EDTA治疗后踝肱指数改善了0.08(95%CI,0.06-0.09)。总体而言,17项研究的结果表明EDTA治疗后患者结局有所改善,5项报告治疗没有统计学上的显著疗效,2项报告没有定性益处。

由此可见,重复使用EDTA治疗CVD可为糖尿病和严重外周动脉疾病患者带来更多益处。给药方案之间的差异,包括剂量、溶液成分和输液次数,限制了研究之间的比较。需要进一步的研究来证实这些结果并评估金属的潜在介导作用。

原始出处:

Filippo Ravalli.et al.Chelation Therapy in Patients With Cardiovascular Disease: A Systematic Review.JAHA.2022.https://www.ahajournals.org/doi/10.1161/JAHA.121.024648

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    2022-03-04 zhaohui6731
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