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在轻微非致残性缺血性中风中静脉输入高位血酶:系统性审查和元分析
Adel Alhazzani1,2, Fahad S Al-Ajlan1,2, Ahmed Alkhiri3,4
1Neuroscience Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
European stroke journal
|March 11, 2024
概括
与没有治疗相比,静脉输入的高血 (IVA) 对轻度缺血性中风患者没有显著的益处. 这次元分析没有发现IVA改善功能结果或增加症状性脑内出血的风险.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 临床研究 临床研究
背景情况:
- 轻度缺血性中风占所有急性缺血性中风的一半.
- 在轻微中风患者中,静脉注射高血 (IVA) 的疗效尚不清楚.
- 这项研究评估了使用IVA或不使用IVA治疗的轻微中风患者的临床结果.
研究的目的:
- 为了确定静脉注射高高酶 (IVA) 在轻度缺血性中风患者的有效性和安全性.
- 为了比较IVA与无-IVA在轻微中风管理中的功能结果和安全性.
主要方法:
- 在主要数据库 (Medline,Embase,Scopus,Cochrane) 进行了系统的文献搜索,直到2023年8月.
- 包括的研究重点是治疗IVA或不治疗IVA的轻微非致残性中风患者,分析疗效 (mRS 0-1,0-2在90天) 和安全性 (sICH).
- 随机效应模型被用于对几率比率 (ORs) 和95%置信区间 (CI) 的聚合分析.
主要成果:
- 包括5项研究 (2项RCT,3项观察性) 涉及2764名患者;56.4%接受了IVA.
- 对RCT的聚合分析显示,在良好的功能性结果 (OR 0.76 [95% CI,0.51-1.13]) 或症状性脑内出血 (sICH) 率 (OR 3.76 [95% CI,0.61-23.20) 中没有显著差异.
- 在IVA和无IVA组之间,在良好的功能结果,90天死亡率或中风复发方面没有发现显著差异.
结论:
- 静脉注射高血压剂 (IVA) 在轻微非致残性中风患者中似乎没有比无IVA提供显著的益处.
- 目前的证据表明,IVA对这个患者亚组没有更多的益处.
- 可能需要进一步的研究来澄清IVA在特定轻微中风病例中的作用.
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