在急性缺血性中风中进行血管内血栓切除后,强化与常规降低血压:OPTIMAL- BP随机临床试验
在PubMed上查看摘要
概括
此摘要是机器生成的。与传统治疗相比,在急性缺血性中风后的强化血压管理导致3个月后功能独立性降低. 这表明在EVT后避免密集的血压控制.
科学领域
- 神经学
- 心脏病学
- 危急护理医学
背景情况
- 对于急性缺血性中风的内血管血栓切除术 (EVT) 后的最佳血压管理仍未确定.
- 有效的血压控制对于改善再注血治疗后的结果至关重要.
研究的目的
- 在急性缺血性中风患者中,强化血压管理与传统血压管理的有效性进行比较.
- 在EVT后24小时内评估BP目标对功能独立性和安全结果的影响.
主要方法
- 一个多中心,随机,开放的试验,涉及306名大血管封闭急性缺血性中风患者.
- 参与者被分配为24小时的密集血压管理 (静脉压<140毫米升) 或常规血压管理 (静脉压140-180毫米升).
- 主要结局是3个月后的功能独立,通过修改的兰金评分 (0 - 2) 进行评估.
主要成果
- 由于安全问题,该试验提前结束. 与传统治疗 (54. 4%) 相比,3个月后,强化血压管理与功能独立率较低有关.
- 两组之间没有观察到症状性脑内出血率的显著差异 (9. 0% 和 8. 1%).
- 与指数中风相关的3个月内死亡率在密集治疗组 (7. 7%) 比常规治疗组 (5. 4%) 高.
结论
- 在成功治疗急性缺血性中风和大血管封闭后的强化血压管理与3个月后更差的功能结果有关.
- 这些发现表明,应避免在这种患者群体中进行密集的血压管理.
- 传统的BP管理似乎是EVT后的更安全和更有效的策略.
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