在成功的内血管血栓切除术后,基于心脏病发作体积的血压管理
Jae Wook Jung1, Kwang Hyun Kim1,2, Jaeseob Yun1,3
1Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
European stroke journal
|May 3, 2025
概括
传统的血压管理改善了中风患者的功能独立性,其中心脏病发作量较小. 血管内血栓切除术后,随着心脏病发作量增加,血压管理策略的益处会减少.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 干预性放射学 干预性放射学
背景情况:
- 血管内血栓切除术 (EVT) 对大型心脏病发作是有效的.
- 不同心脏病发作体积的EVT后最佳血压 (BP) 管理还没有得到很好的定义.
研究的目的:
- 为了研究血压管理对接受EVT的患者功能结果的影响,按心脏病发作量分层.
- 根据心脏病发作的大小,确定密集与传统血压控制对结果的影响是否不同.
主要方法:
- 对OPTIMAL-BP试验 (NCT04205305) 的二次分析.
- 在EVT后24小时内,强化 (静脉血压<140 mmHg) 与传统 (静脉血压140-180 mmHg) 血压管理进行比较.
- 通过心脏病发作体积分层的患者 (≤50毫升 vs. >50毫升) 在EVT后24小时.
主要成果:
- 传统的血压管理与心脏病发作量≤50毫升组 (AOR 2.06) 的更高的功能独立性有关.
- 对于心脏病发作量>50毫升 (AOR 1.52) 的血压管理组之间功能独立性没有显著差异.
- 随着心脏病发作量增加,BP管理策略之间的功能独立预测概率的差异下降.
结论:
- 传统的血压管理在EVT后的较小心脏病发作量中对功能独立性更有好处.
- 高血压管理策略对功能结果的影响随着心脏病发作量增加而减少.
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