症状性内动脉硬化狭窄症的内血管治疗与传统医学治疗:随机对照试验的更新元分析
在PubMed上查看摘要
概括
此摘要是机器生成的。对症状性内动脉缩症 (sICAS) 的内血管治疗 (ET) 加上常规医学治疗 (CMT) 会增加短期死亡和中风的风险. 目前的证据不支持辅助ET用于SICAS管理.
科学领域
- 神经学
- 干预心脏病学
- 血管外科
背景情况
- 症状性内动脉缩症 (sICAS) 是缺血性中风的常见原因.
- 尽管使用常规药物治疗 (CMT),但复发率仍然很高.
研究的目的
- 为了比较内血管治疗 (ET) 加CMT与单独CMT的短期和长期结果.
- 评估助剂ET在治疗sICAS中的有效性和安全性.
主要方法
- 五项涉及1531名患者的随机对照试验 (RCT) 的系统综述和元分析.
- 通过主要数据库进行搜索:PubMed,Cochrane CENTRAL,WOS,SCOPUS和Embase.
- 用于评估治疗效果的95%置信区间 (CI) 的几率比率 (OR).
主要成果
- ET加上CMT显著增加了短期死亡率或中风的几率 (OR,3. 19;P < 0. 01),包括较高的死亡率 (OR,4. 35;P = 0. 02),缺血性中风 (OR,2.26;P < 0. 01) 和出血性中风 (OR,10. 74;P < 0. 01).
- 长期结果没有显著差异,除了长期显著增加的ET出血性中风风险 (OR,5. 14;P < 0. 01).
- 两组之间暂时性缺血发作率没有差异 (OR,0. 87;P = 0. 78).
结论
- 辅助内血管治疗 (ET) 与常规医学治疗 (CMT) 结合,增加了症状内动脉缩症 (sICAS) 患者因任何原因死亡,缺血性中风和出血性中风的风险.
- 目前的证据不支持在sICAS患者中常规使用辅助ET.
- 可能需要进一步的研究来确定可能受益于ET的特定患者子组.
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