经过缺血性中风的EVT后,强化与传统的BP管理相比,在3个月内降低了功能独立性
1University of Calgary-Foothills Medical Centre, Calgary, Alberta, Canada (M.D.H.).
Annals of internal medicine
|January 1, 2024
概括
针对急性缺血性中风的内血管血栓切除术后,强化降低血压并没有与传统降低相比显著改善结果. 这一发现影响了中风治疗指南和患者护理策略.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 临床试验 临床试验
背景情况:
- 急性缺血性中风是导致残疾的主要原因.
- 血管内血栓切除术改善了符合条件的患者的治疗结果.
- 脑卒中后的血压管理至关重要,但仍有争议.
研究的目的:
- 为了比较密集与传统的降血压.
- 评估内血管血栓切除术后对功能结果的影响.
- 为了告知最佳的中风后高血压管理.
主要方法:
- 在OPTIMAL-BP随机临床试验.
- 包括因急性缺血性中风而接受内血管血栓切除术的患者.
- 随机化为密集的 (静态血压<120 mmHg) 或常规的 (静态血压<140 mmHg) 血压目标.
主要成果:
- 两组之间90天后修改的兰金级分数没有显著差异.
- 症状性内出血和死亡率相似.
- 强烈的血压降低需要更多的抗高血压药物.
结论:
- 密集降低血压并没有优于常规降低功能性结局后的血栓切除术.
- 在这种情况下,目前关于血压管理的指导方针可能是适当的.
- 进一步的研究可能会探索特定的患者子组.
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