急性缺血性中风后的抗高血压治疗:继续还是不继续?
Chongke Zhong1, Ming Wang1, Dacheng Liu2
1Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, China (C.Z., Ming Wang, T.X., Y.Z.).
Hypertension (Dallas, Tex. : 1979)
|December 5, 2025
概括
在急性缺血性中风后立即继续服用抗高血压药物并没有改变已经服用这些药物的患者的结果. 早期或延迟开始治疗对预防死亡或严重残疾没有显著差异.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 临床试验 临床试验
背景情况:
- 在急性缺血性中风后管理抗高血压治疗是一个临床挑战.
- 关于立即延续与延迟开始抗高血压治疗存在不确定性.
研究的目的:
- 评估在急性缺血性中风患者中继续现有的抗高血压治疗的影响.
- 为了比较立即与暂停的抗高血压治疗 (CATIS试验) 和早期与延迟的治疗 (CATIS-2试验).
主要方法:
- 进行了来自中国抗高血压试验中的急性缺血性中风 (CATIS) 和CATIS-2的子组分析.
- CATIS:4071名患者随机分配到立即或中止的抗高血压治疗.
- CATIS-2:4810名患者随机分配到早期 (24-48小时) 或延迟 (8日) 的抗高血压治疗.
主要成果:
- 在CATIS中,与停止治疗相比,立即连续的抗高血压治疗在主要结果 (死亡/严重残疾) 中没有显著差异.
- 在CATIS-2中,早期开始抗高血压治疗与延迟开始对主要结果没有显著差异.
- 在中风前不服用抗高血压药物的患者中,结果在两组之间是相似的.
结论:
- 早期延续抗高血压治疗不会显著改变中风前使用抗高血压药物的患者的不良临床结果.
- 无论是立即启动还是早期启动抗高血压疗法,都没有在这个患者群体中显示出益处.
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