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左心室喷射率<60%与急性缺血性中风患者的短期功能障碍有关
Guojuan Chen1,2, Peng Ding1, Liqin Yang1
1Department of Neurology, Clinical College of Neurology, Neurosurgery, and Neurorehabilitation, Tianjin Medical University, Tianjin Huanhu Hospital, Tianjin, China.
减少左心室喷射分数 (LVEF) 与急性缺血性中风 (AIS) 患者的功能结果更差有关. 早期发现和预防心脏功能障碍可能会改善中风恢复.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 脑卒中医学 脑卒中医学
背景情况:
- 在急性缺血性中风 (AIS) 中,心脏功能障碍和功能结果之间的关系需要进一步澄清.
- 左心室喷射率 (LVEF) 是一个常规评估的心脏参数.
研究的目的:
- 研究AIS患者的LVEF和功能性结局之间的关联.
- 探索减少LVEF对AIS患者死亡率,神经系统恶化,住院和成本的影响.
主要方法:
- 一项前性,观察性,单中心研究 (SPARK) 涉及1181名AIS患者.
- 在中风发作后7天内通过胸前回声心脏成像评估LVEF.
- 主要结局:功能障碍 (90天后修改的兰金尺度3-6);次要结局包括死亡率,神经系统恶化,住院和费用. 使用多变量逻辑回归和倾向得分匹配 (PSM).
主要成果:
- 降低的LVEF (<60%) 与90天后的功能障碍显著相关 (OR:1.85,95%CI:1.01-3.40),在PSM后的相关性更强 (OR:5.32,95%CI:3.04-9.30).
- 与死亡率,早期神经系统恶化,住院和成本的关联并不总是显著的.
- 减少LVEF和功能障碍之间的关联在非心血管血栓性中风中显著,但在心血管血栓性中风中没有.
结论:
- 降低LVEF (<60%) 增加了AIS患者功能障碍的风险.
- 未来的策略专注于预防心脏功能障碍在中风的急性阶段是有必要的.
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