在内血管治疗后无症状出血转变对中风结果的影响:基于人口的研究
Marina Guasch-Jiménez1, Garbiñe Ezcurra Díaz1, Álvaro Lambea-Gil1
1Stroke Unit, Neurology Department, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (Department of Medicine), Spain.
Neurology
|April 14, 2025
概括
在急性缺血性中风 (AIS) 进行内血管治疗 (EVT) 后,无症状的出血转变 (HT) 与更糟糕的结果和增加的死亡率有关. 这表明所有HT事件,无论症状如何,都应在EVT安全协议中考虑.
科学领域:
- 神经学 神经学
- 干预性神经辐射学
- 脑卒中医学 脑卒中医学
背景情况:
- 已知急性缺血性中风 (AIS) 内血管治疗 (EVT) 后的出血转化 (HT) 在临床上明显时会使结果恶化.
- 无症状HT对中风结果和死亡率的影响仍然不太清楚.
研究的目的:
- 在AIS患者中调查无症状HT和功能性结局3个月后EVT之间的关联.
- 为了确定无症状的HT是否会影响EVT后的死亡率.
主要方法:
- 来自10个西班牙中心 (2017-2023) 的潜在中风注册表的分析,包括接受EVT的前部循环AIS患者.
- 高血压被分类为 (HI,PH,rPH),无症状高血压被定义为没有显著临床恶化 (NIHSS增加≥4分或死亡) 的高血压.
- 多变量顺序回归模型评估了无症状HT与3个月修改的兰金尺度 (mRS) 评分和死亡率的关联,调整了关键的临床和成像变量.
主要成果:
- 在3,067名患者中,612名 (20.0%) 患有无症状的HT.
- 无症状的HT显着与功能结果较差 (cOR2.24) 和死亡率较高 (aOR1.50) 相关.
- 敏感性分析证实了不同HT类别之间的关联,无症状PH2显示最高风险 (cOR 3.15).
结论:
- 对AIS进行EVT后的无症状HT是不良功能结果和死亡率增加的重要预测因素.
- 这些发现强调了在对EVT的安全性评估中考虑所有HT事件的重要性,无论是否有症状.
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