术前β受体阻滞剂对肝移植术中循环管理及术后短期心肌损伤和脑卒中的影响:一项倾向评分匹配研究

傅洪; Victor W. Xia

doi:10.16016/j.1000-5404.201906220

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术前β受体阻滞剂对肝移植术中循环管理及术后短期心肌损伤和脑卒中的影响:一项倾向评分匹配研究

临床医学 | 更新时间：2026-01-09

- 术前β受体阻滞剂对肝移植术中循环管理及术后短期心肌损伤和脑卒中的影响:一项倾向评分匹配研究
- Effects of preoperative beta blockers on intraoperative circulation management and short-term myocardial injury and stroke after liver transplantation: a propensity-matched study
- 第三军医大学学报 2019年41卷第23期页码：2355-2360
- 作者机构：
- 作者简介：
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- DOI：10.16016/j.1000-5404.201906220
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- 收稿：2019-06-26，
  
  纸质出版：2019-12-15
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傅洪, Victor W. Xia. 术前β受体阻滞剂对肝移植术中循环管理及术后短期心肌损伤和脑卒中的影响:一项倾向评分匹配研究[J]. 第三军医大学学报, 2019,41(23):2355-2360.

Hong FU, W. Xia Victor. Effects of preoperative beta blockers on intraoperative circulation management and short-term myocardial injury and stroke after liver transplantation: a propensity-matched study[J]. Journal of Third Military Medical University, 2019, 41(23): 2355-2360.
傅洪, Victor W. Xia. 术前β受体阻滞剂对肝移植术中循环管理及术后短期心肌损伤和脑卒中的影响:一项倾向评分匹配研究[J]. 第三军医大学学报, 2019,41(23):2355-2360. DOI： 10.16016/j.1000-5404.201906220.

Hong FU, W. Xia Victor. Effects of preoperative beta blockers on intraoperative circulation management and short-term myocardial injury and stroke after liver transplantation: a propensity-matched study[J]. Journal of Third Military Medical University, 2019, 41(23): 2355-2360. DOI： 10.16016/j.1000-5404.201906220.

摘要

Abstract

Objective

To retrospectively analyze the effect of preoperative use of β-blockers on blood transfusion volume

use of pressor drugs

post-reperfusion syndrome

and incidence of heart muscle injury and stroke within 30 d after operation during liver transplantation (LT) by a propensity-matched study.

Methods

A retrospective study was performed on the patients who underwent LT at UCLA Ronald Reagan medical center between October 2005 and September 2014 after the approval of the Institutional Review Board of the university (IRB#11-003058). According to the preoperative use of β-blockers or not

these patients were divided into β-blockers group (

=643) and non β-blockers group (

=809). The difference of preoperative variables between the 2 groups was analyzed by single factor analysis. The variables with a value of

0.05 and those of important relevant clinical status were selected in a logistic regression model to generate a propensity score for each patient. The patients in 2 groups were matched in 1: 1 with the nearest propensity scores. The amount of blood transfusion

use of vasopressors

incidence of post-reperfusion syndrome

and occurrence of myocardial injury and stroke within 30 d after LT were compared between the 2 groups.

Results

Based on the clinical data of 2 102 patients recruited in this study

single factor analysis showed that the patients of the β-blocker

group were significantly older

larger proportion of males

and higher incidences of hypertension

coronary artery disease

diabetes

and gastrointestinal bleeding. The results of logistic regression analysis eliminated after propensity match (442 patients in each group

totally 884 patients) indicated that there were no significant differences in the amount of intraoperative blood transfusion (18.8±16.1

20.3±18.0 U

=0.155)

administration of vasopressors (77.4%

79.0%

=0.556)

incidence of post-reperfusion syndrome (14.7%

14.9%

=0.901)

and occurrence of myocardial injury (3.8%

4.3%

=0.761) and stroke (0.7%

2.0%

=0.143) within 30 d after LT between the 2 matched groups.

Conclusion

Preoperative use of β-blockers for over 7 d has no effect on amount of blood transfusion

use of vasopressors

incidence of post-reperfusion syndrome

and occurrence of myocardial injury and stroke within 30 d after LT. The drug can be continuously administered for the patients with end-stage liver disease before undergoing LT.

关键词

Keywords

references

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