在患有非常大的缺血性核心中风的患者中,内血管治疗和结果
Dongjing Xie1, Jiacheng Huang1, Shitao Fan1
1Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
在阿尔伯塔中风计划早期计算机断层扫描得分 (ASPECTS) 非常低的中风患者的内血管治疗 (EVT) 与改善的功能结果有关. 然而,与标准医疗治疗相比,EVT也增加了症状性脑内出血的风险.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 干预心脏病学 干预心脏病学
背景情况:
- 对于阿尔伯塔中风计划早期计算机断层扫描得分 (ASPECTS) 非常低的患者,急性缺血性中风的内血管治疗 (EVT) 的有效性仍然不确定.
- 非对比计算断层扫描 (NCCT) 对于初始中风评估至关重要,ASPECTS 可以量化早期的缺血变化.
研究的目的:
- 调查EVT与患者的功能和安全结果之间的关联,在中风发作后24小时内,患者的ASPECT值为0至2.
主要方法:
- 中国的一项前性,观察性,全国性队列研究包括245名ASPECT 0-2.
- 患者接受了EVT或标准医疗治疗 (SMT).
- 结局包括功能状态 (修改的兰金度数得分0-3在90天),症状性脑内出血 (sICH) 和死亡率在90天.
主要成果:
- 与SMT相比,EVT与90天的良好功能结果的几率明显更高 (22.2%对9.9%).
- 此外,EVT还导致在48小时内发生任何脑内出血 (ICH) 和SICH的几率显著增加.
- 在EVT和SMT组之间没有观察到90天死亡率的显著差异.
结论:
- 在中风后24小时内,在NCCT方面非常低的患者中,EVT可能会改善功能结果,但会增加ICH的风险.
- 进一步的随机临床试验是有必要的,以确认这些发现,并建立最佳的治疗策略.
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