| 摘要: | 在這項研究中，我們主旨在調查用於新陳代謝症候群的治療藥物對於手術併發症的影響。我們在2016年根據2624名手術患者的病歷進行了回顧性病例對照研究。使用雙元邏輯回歸分析了從醫院紀錄中獲得的手術併發症的數據。自變項包括血管緊張素轉換?抑製劑(angiotensin-converting-enzyme inhibitor)，血管緊張素受體阻滯劑 (angiotensin receptor blocker)，二氫?啶類鈣通道阻滯劑 (dihydropyridine calcium-channel blockers)，利尿劑，保鉀利尿劑 (potassium-sparing diuretics)，非二氫?啶類鈣通道阻滯劑 (non-dihydropyridine calcium-channel blockers)，二?基??抑製劑 (dipeptidyl peptidase-4 inhibitor)，胰高血糖素樣?受體激動劑 (glucagon-like peptide-1 receptor agonists)，非選擇性β受體阻滯劑 (nonselective beta-blockers)，選擇性β-阻滯劑，週邊血管擴張劑，α-葡糖??抑製劑 (alpha-glucosidase inhibitors)，胰島素，二甲雙胍 (metformin)，磺??類 (sulfonylureas)，?唑烷二酮類 (thiazolidinediones)，膽汁酸多價螯合劑 (sequestrants)，他汀類藥物 (statins)。依變項是手術併發症。在包括在研究中的外科患者中，328名（12.5％）具有新陳代謝症候群病史。在具有相同嚴重度評分（大於等於美國麻醉醫師協會分類第三級）的疾病中，使用利尿劑，非二氫?啶類鈣通道阻滯劑，二氫?啶類鈣通道阻滯劑，胰島素，胰高血糖素樣?受體激動劑和選擇性β受體阻滯劑在單變量邏輯回歸中具有顯著影響。然而，使用控制變量的多變量邏輯回歸顯示僅利尿劑的使用具有統計學顯著性[勝算比值1.968,95％信賴區間1.141-3.394，P = 0.015]。雖然只有利尿劑顯示出顯著的相關性，但是用於治療新陳代謝性的其他幾種藥物都具有手術併發症的風險。
In this study, we aimed to investigate the effects of therapeutic agents used for the treatment of metabolic syndrome (MS) on surgical complications. We performed a retrospective case-control study based on chart reviews of 2624 surgical patients at our hospital in 2016. Data regarding surgical complications obtained from the hospital records were analyzed using binary logistic regression. The independent variables were angiotensin-converting-enzyme inhibitor, angiotensin receptor blocker, dihydropyridine calcium-channel blockers (DCCB), diuretics, potassium-sparing (K+-sparing) diuretics, non-dihydropyridine calcium-channel blockers (NDCCB), dipeptidyl peptidase-4 inhibitor, glucagon-like peptide-1 receptor agonists (GLP1 agonists), nonselective beta-blockers, selective beta-blockers, peripheral vasodilators, alpha-glucosidase inhibitors, insulin, metformin, sulfonylureas, thiazolidinediones, bile acid sequestrants, fibrates, and statins. The dependent variable was surgical complications. Among the surgical patients included in the study, 328(12.5%) had a history of metabolic syndrome. In diseases with the same severity score [ ? American Society of Anesthesiologists (ASA) 3], diuretics, NDCCB, DCCB, insulin, GLP1 agonists, and selective beta-blockers had a significant influence in univariate logistic regression. However, multivariate logistic regression using control variables showed that only diuretic use was statistically significant [odds ratio (OR) 1.968, 95% confidence interval III (CI) 1.141–3.394, P = 0.015]. Several medications used for the treatment of metabolic syndrome pose a risk for surgical complications, although only diuretics showed a significant association. |
