远程缺血调节与常规护理对急性中度缺血中风患者神经功能的影响:RICAMIS随机临床试验
Hui-Sheng Chen1, Yu Cui1, Xiao-Qiu Li1
1Department of Neurology, General Hospital of Northern Theatre Command, Shenyang, China.
JAMA
|August 16, 2022
概括
远程缺血调节 (RIC) 改善了急性中度缺血中风患者的功能结果. 需要进一步的试验来证实这种神经保护干预的有效性.
科学领域:
- 神经学
- 心血管医学
- 临床试验
背景情况:
- 临床前和临床研究表明远程缺血调节 (RIC) 的神经保护作用.
- 对急性缺血性中风患者的RIC疗效的证据有限.
- RIC涉及重复的肢体动脉封闭/释放周期.
研究的目的:
- 评估RIC作为急性中度缺血性中风的辅助治疗的有效性.
- 为了确定RIC是否改善了中风后90天的功能结果.
主要方法:
- 进行了一项多中心,开放的,盲目的随机临床试验.
- 有1893名急性中度缺血性中风患者被随机分组.
- 患者接受了RIC加上基于指南的治疗或仅基于指南的治疗.
主要成果:
- 在90天后,RIC组的67. 4%和对照组的62. 0%的患者获得了优异的功能结果 (修改的兰金尺度0 - 1).
- 在RIC中,表现出优异的功能性结果有显著的增加 (风险差异为5. 4%).
- 在RIC和对照组中,不良事件的发生率相似.
结论:
- 在患有急性中等性缺血性中风的成年人中,远程缺血性调节显著增加了在90天内良好神经功能的可能性.
- 这些发现表明RIC可能是中风恢复的有益干预措施.
- 建议在其他试验中进行复制,以确定RIC的疗效.
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