在缺血性中风后,胃肠道出血的长期发生率
Jun Yup Kim1, Beom Joon Kim1, Jihoon Kang1
1Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Journal of stroke
|February 7, 2025
概括
患有急性缺血性中风 (AIS) 的患者面临严重胃肠道出血 (GIB) 的高风险,特别是在中风后的第一个月内. 早期干预对高风险个体至关重要,包括那些患有贫血或功能受损的人.
科学领域:
- 神经学 神经学
- 胃肠病学 胃肠病学
- 临床研究 临床研究
背景情况:
- 在急性缺血性中风 (AIS) 患者中,主要胃肠道出血 (GIB) 发生率在住院期间报告为0.5%.
- 长期GIB发生率及其对AIS结果的影响研究不足.
研究的目的:
- 调查AIS患者长期发生的主要GIB的发生率.
- 在这个患者群体中确定主要GIB的预测因子.
主要方法:
- 分析了全国多中心潜在中风注册 (2011-2013) 数据.
- 10,818名AIS患者的随访时间长达6年.
- 主要GIB (≥2单位输血) 通过国家医疗保险服务索赔追踪.
主要成果:
- 8.8%的AIS患者 (947/10,818) 在中位数3.1年的随访期间经历了主要的GIB.
- 在AIS后的第一个月,发病率达到每100人/年19.2的峰值,然后下降.
- 主要GIB的预测因素包括贫血,eGFR<60,和修改的兰金级评分≥4在3个月.
结论:
- 患有AIS的患者具有重大GIB的显著风险,特别是在最初的月份.
- 风险随着时间的推移而减少,但需要持续保持警.
- 对于高风险患者 (贫血,功能障碍,残疾) 建议采取预防策略.
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