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成功内血管治疗后的血压:随机对照试验的系统审查和元分析

Khaled Gharaibeh^1,2, Nameer Aladamat¹, Adam T Mierzwa^1,2

¹Department of Neurology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.

Annals of neurology

|March 14, 2024

概括

机械血栓切除术后对大血管闭塞进行密集的血压控制可能会降低功能独立性. 这次系统性审查发现,密集和常规BP管理之间的优异结果,出血或死亡率没有显著差异.

科学领域:

神经学神经学
干预神经病学干预神经病学
临床试验临床试验

背景情况:

对于大血管封闭 (LVO) 的机械血栓切除术 (MT) 后最佳血压 (BP) 管理的数据有限.
了解血压控制对MT后患者结果的影响对于急性缺血性中风护理至关重要.

研究的目的:

系统地审查和元分析随机对照试验 (RCT),比较MT后的密集与常规BP控制.
评估不同BP目标在功能独立,优异结果,症状内出血 (sICH) 和死亡率方面的疗效和安全性.

主要方法:

在PubMed和Embase进行了系统的文献搜索,寻找2023年9月为止MT后的BP控制研究.
四个涉及1566名患者的RCT被纳入了分析.
主要结局:3个月的功能独立 (修改的兰金尺度[mRS] 0-2). 二次结果:优异的结果 (mRS 0-1),SICH和死亡率.

主要成果:

强化血压控制与3个月后功能独立 (mRS 0-2) 的可能性较低有关 (OR:0.68,95% CI:0.51-0.91,p=0.009).
在强化和常规血压控制组之间,在优秀结果 (mRS 0-1),SICH风险或死亡率方面没有观察到统计学上显著的差异.

结论:

在LVO急性缺血性中风的成功MT患者中,密集的血压控制与3个月后功能独立性降低有关.
与传统的BP控制相比,密集的BP管理并没有显著改变优异结果,SICH或死亡率的可能性.

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