对于急性中风的远程缺血调节:RESIST随机临床试验
Rolf Ankerlund Blauenfeldt1,2, Niels Hjort1,2, Jan Brink Valentin3
1Danish Stroke Center, Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
JAMA
|October 3, 2023
概括
远程缺血调节 (RIC) 没有改善急性中风患者在医院前和医院内持续的功能结果. 这种治疗在90天后没有显著的减轻残疾.
科学领域:
- 神经学
- 心血管医学
- 临床试验
背景情况:
- 远程缺血调节 (RIC) 涉及肢体缺血和再注血的周期.
- 关于急性中风的临床前和临床数据显示出一些前景.
- 对于急性中风的医院前启动的RIC的有效性仍然不确定.
研究的目的:
- 评估RIC在急性中风患者的功能结局上的影响,该疗程在医院前开始,并在医院内继续.
- 为了确定RIC是否改善了修改后的兰金尺度 (mRS) 分数.
主要方法:
- 这是一项随机临床试验,涉及1500名急性中风患者.
- 使用充气袖子进行RIC,充气和通缩循环.
- 在救护车中开始治疗,并在医院继续治疗长达7天.
主要成果:
- 在902名确诊中风患者中,RIC在90天后没有显著改善功能结果 (mRS转移:OR,0. 95;P=.67).
- 在RIC和虚假组之间没有观察到严重不良事件的显著差异.
- 在RIC组中,上肢疼痛和皮肤的发病率增加.
结论:
- 在急性中风患者中,医院前启动的RIC并未显著改善功能结果.
- 这项研究不支持使用RIC作为一种有效的治疗方法来改善急性中风的功能结果.
- 可能需要进一步的研究来探索RIC在中风管理中的潜在益处或替代方案.
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