Background:The maintenance dosage of selexipag is categorized as low,medium or high.In order to assess the efficacy and safety of different dosages of selexipag for the risk stratification of pulmonary arterial hypert...Background:The maintenance dosage of selexipag is categorized as low,medium or high.In order to assess the efficacy and safety of different dosages of selexipag for the risk stratification of pulmonary arterial hypertension(PAH),we performed a sys-tematic review and meta-analysis.Methods:Studies assessing PAH risk stratification indices,such as the World Health Organization functional class(WHO-FC),six-minute walk distance(6MWD),N-terminal pro-B-type natriuretic peptide(NT-proBNP)level,right atrial pressure(RAP),cardiac index(CI)and mixed venous oxygen saturation(SvO2),were included.Results:Thirteen studies were included.Selexipag led to improvements in the 6MWD(MD:24.20 m,95%CI:10.74-37.67),NT-proBNP(SMD:-0.41,95%CI:-0.79-0.04),CI(MD:0.47 L/min/m^(2),95%CI:0.17-0.77)and WHO-FC(OR:0.564,95%CI:0.457-0.697).Subgroup analysis demonstrated that all three dosages improved the 6MWD.A moderate dosage led to improvements in the CI(MD:0.30 L/min/m^(2),95%CI:0.15-0.46)and WHO-FC(OR:0.589,95%CI:0.376-0.922).Within 6 months of treatment,only the WHO-FC and CI were significantly improved(OR:0.614,95%CI:0.380-0.993;MD:0.30 L/min/m^(2),95%CI:0.16-0.45,respectively).More than 6 months of treatment significantly improved the 6MWD,WHO-FC and NT-proBNP(MD:40.87 m,95%CI:10.97-70.77;OR:0.557,95%CI:0.440-0.705;SMD:-0.61,95%CI:-1.17-0.05,respectively).Conclusions:Low,medium,and high dosages of selexipag all exhibited good effects.When treatment lasted for more than 6 months,selexipag exerted obvious effects,even in the low-dosage group.This finding is important for guiding individualized treatments.展开更多
目的对近10年肺动脉高压(PH)领域研究的前沿和热点进行分析,为该领域以后的研究提供一定参考。方法检索Web of Science数据库核心合集中2012-2021年PH领域相关文献,运用CiteSpace软件对作者、机构、国家进行共现分析,并对关键词进行聚...目的对近10年肺动脉高压(PH)领域研究的前沿和热点进行分析,为该领域以后的研究提供一定参考。方法检索Web of Science数据库核心合集中2012-2021年PH领域相关文献,运用CiteSpace软件对作者、机构、国家进行共现分析,并对关键词进行聚类分析及burst分析。结果共纳入相关文献12774篇。分析结果显示,近年来PH领域的研究呈上升趋势,该领域发文量最多的是美国;研究机构中加州大学圣地亚哥分校有较高学术影响力;发文量10篇以上的该领域核心作者共130位。PH领域的研究热点主要集中在发病机制、早期诊断与预后、靶向药物、新生儿持续PH和肺纤维化相关PH等方面。结论近10年来,PH领域的研究热点不断更新。新型靶向药物、生物标志物在诊断与预后中的价值是未来的重点研究方向。展开更多
基金Program of the National Natural Science Foundation of China,Grant/Award Number:81700045,81870042 and 82200065The Department Development Fund of Shanghai Pulmonary Hospital,Grant/Award Number:201906-0314+2 种基金The Program of Shanghai Pulmonary Hospital,Grant/Award Number:FKLY20011The Three-year Action Plan to Promote Clinical Skills and Clinical Innovation in Municipal Hospitals,Grant/Award Number:SHDC2020CR4021Young Talent Program of Shanghai Municipal Health Commission,Grant/Award Number:2022YQ070。
文摘Background:The maintenance dosage of selexipag is categorized as low,medium or high.In order to assess the efficacy and safety of different dosages of selexipag for the risk stratification of pulmonary arterial hypertension(PAH),we performed a sys-tematic review and meta-analysis.Methods:Studies assessing PAH risk stratification indices,such as the World Health Organization functional class(WHO-FC),six-minute walk distance(6MWD),N-terminal pro-B-type natriuretic peptide(NT-proBNP)level,right atrial pressure(RAP),cardiac index(CI)and mixed venous oxygen saturation(SvO2),were included.Results:Thirteen studies were included.Selexipag led to improvements in the 6MWD(MD:24.20 m,95%CI:10.74-37.67),NT-proBNP(SMD:-0.41,95%CI:-0.79-0.04),CI(MD:0.47 L/min/m^(2),95%CI:0.17-0.77)and WHO-FC(OR:0.564,95%CI:0.457-0.697).Subgroup analysis demonstrated that all three dosages improved the 6MWD.A moderate dosage led to improvements in the CI(MD:0.30 L/min/m^(2),95%CI:0.15-0.46)and WHO-FC(OR:0.589,95%CI:0.376-0.922).Within 6 months of treatment,only the WHO-FC and CI were significantly improved(OR:0.614,95%CI:0.380-0.993;MD:0.30 L/min/m^(2),95%CI:0.16-0.45,respectively).More than 6 months of treatment significantly improved the 6MWD,WHO-FC and NT-proBNP(MD:40.87 m,95%CI:10.97-70.77;OR:0.557,95%CI:0.440-0.705;SMD:-0.61,95%CI:-1.17-0.05,respectively).Conclusions:Low,medium,and high dosages of selexipag all exhibited good effects.When treatment lasted for more than 6 months,selexipag exerted obvious effects,even in the low-dosage group.This finding is important for guiding individualized treatments.
文摘目的对近10年肺动脉高压(PH)领域研究的前沿和热点进行分析,为该领域以后的研究提供一定参考。方法检索Web of Science数据库核心合集中2012-2021年PH领域相关文献,运用CiteSpace软件对作者、机构、国家进行共现分析,并对关键词进行聚类分析及burst分析。结果共纳入相关文献12774篇。分析结果显示,近年来PH领域的研究呈上升趋势,该领域发文量最多的是美国;研究机构中加州大学圣地亚哥分校有较高学术影响力;发文量10篇以上的该领域核心作者共130位。PH领域的研究热点主要集中在发病机制、早期诊断与预后、靶向药物、新生儿持续PH和肺纤维化相关PH等方面。结论近10年来,PH领域的研究热点不断更新。新型靶向药物、生物标志物在诊断与预后中的价值是未来的重点研究方向。
