在缺血性中风中长期的结果TOAST亚型:在中国进行了一项为期12年的队列研究
Jing Yang1, Chenyao Wu2, Yu Jin1
1Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University 610041, PR China.
概括
缺血性中风 (IS) 的长期结果因亚型而异. 抗凝固药对心血管栓塞 (CE) 患者有益,而抗血小板药可能会限制小动脉阻塞 (SAO) 病例的功能恢复.
科学领域:
- 神经学 神经学
- 心血管研究研究心血管研究
- 公共卫生 公共卫生
背景情况:
- 已知 Org 10172 在急性中风治疗 (TOAST) 试验亚型中短期缺血性中风 (IS) 预后的差异.
- 不同IS亚型的长期结果,特别是在中国,仍未得到充分研究.
- 研究IS亚型与抗血栓治疗之间的相互作用对于了解长期预后至关重要.
研究的目的:
- 为了研究中国首次出现缺血性中风 (IS) 的患者的长期结果.
- 探索IS亚型和抗血栓治疗对患者预后的潜在相互作用影响.
- 根据IS亚型提供基于证据的建议,以优化基于IS亚型的中风护理.
主要方法:
- 来自西中国医院的950名首次IS患者 (2010-2019) 的前性队列研究.
- 长期跟踪至2022年9月,以评估复发率,死亡率和功能恢复 (修改的兰金尺度).
- 用于复发和死亡率分析的多变量细灰和考克斯回归模型;用于功能恢复的通用线性混合效应模型.
主要成果:
- 与大动脉动脉样硬化 (LAA) 相比,心脏栓塞 (CE) 的死亡风险最高 (HR=4.43).
- 抗凝剂治疗降低了CE患者的死亡风险 (HR=0.18).
- 小动脉封闭 (SAO) 显示出良好的功能恢复 (β=-2.08),但抗血小板治疗与LAA (β=1.39) 相比显示出更慢的恢复.
结论:
- 第一次IS后的长期结果在TOAST亚型之间存在显著差异.
- 抗凝固药物治疗为CE患者提供了长期生存益处.
- 抗血小板药物改善SAO患者功能恢复的疗效可能有限,需要仔细考虑治疗.
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