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  2. 治疗急性缺血性中风后的血压管理:best-ii随机临床试验
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  2. 治疗急性缺血性中风后的血压管理:best-ii随机临床试验

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治疗急性缺血性中风后的血压管理:BEST-II随机临床试验

Eva A Mistry1, Kimberly W Hart2, Larry T Davis3

  • 1Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio.

JAMA
|September 5, 2023

在PubMed 上查看摘要

概括
此摘要是机器生成的。

在治疗急性缺血性中风后降低静脉血压 (SBP) 到< 140 mm Hg 或< 160 mm Hg 没有达到无效性标准. 然而,未来的试验不太可能从这些较低的SBP目标中获益.

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科学领域:

  • 神经学
  • 心脏病学
  • 临床试验

背景情况:

  • 对于急性缺血性中风的内血管治疗后的最佳静脉血压 (SBP) 目标仍然不确定.
  • 之前的研究没有明确地确定较低SBP目标的有效性.

研究的目的:

  • 在急性缺血性中风患者中,针对较低的SBP水平 (< 140 mm Hg或< 160 mm Hg) 与较高的目标水平 (≤ 180 mm Hg) 的无用性.
  • 评估SBP目标对心脏病体积和功能结果的影响.

主要方法:

  • 一个2期随机的,开放的,无效的临床试验,涉及120名急性缺血性中风患者.
  • 在24小时内血管治疗后,患者被随机分配到SBP目标值< 140 mm Hg,< 160 mm Hg或≤180 mm Hg.
  • 主要结局包括随访心脏病体积和使用权重修改的兰金度量表 (mRS) 评分,分析无效性.

主要成果:

  • 与≤180mmHg目标相比,较低的SBP目标 (<140mmHg和<160mmHg) 不符合预先指定的无用性标准.
  • 平均心脏病发作量为32. 4毫升 (< 140),50. 7毫升 (< 160) 和46. 4毫升 (≤ 180).
  • 平均使用权重的mRS得分为0. 51 (< 140),0. 47 (< 160) 和0. 58 (≤ 180).
  • 未来试验的成功概率很低 (< 140 mm Hg 的概率为 25%,< 160 mm Hg 的概率为 14%).
  • 结论:

    • 在急性缺血性中风的内血管治疗成功后降低SBP至< 140 mm Hg或< 160 mm Hg并没有显示无效.
    • 结果表明,在更大的试验中追求这些较低的SBP目标的益处很低.
    • 目前指南推的SBP目标值在该患者群体中为≤180 mm Hg似乎是合理的.