在急性缺血性中风的内血管治疗后与对比相关的急性损伤:元分析
Hong-Jie Jhou1,2, Po-Huang Chen3, Li-Yu Yang1,2
1Department of Neurology Changhua Christian Hospital Changhua Taiwan.
Stroke (Hoboken, N.J.)
|January 26, 2026
概括
在急性缺血性中风的内血管治疗 (EVT) 后,对比剂相关的急性损伤 (CA-AKI) 和替代疗法 (RRT) 的风险很低. 由于对功能的担忧,EVT的治疗不应推迟.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 神经学 神经学
- 放射学 放射学是一门学科.
背景情况:
- 急性缺血性中风 (AIS) 管理通常涉及内血管治疗 (EVT).
- 在EVT中使用的对比介质构成损伤的潜在风险.
- 与对比相关的急性损伤 (CA-AKI) 和需要置换疗法 (RRT) 是潜在的并发症.
研究的目的:
- 调查AIS患者在EVT后的CA-AKI和RRT发生率.
- 在这个患者群体中确定与CA-AKI和RRT相关的因素.
主要方法:
- 在PubMed,Cochrane图书馆和Web of Science进行了系统的文献搜索,直到2021年7月.
- 使用随机效应模型与双弧形变换的元分析被用来组合发病率.
- 进行了子组和元回归分析,以探索影响因素.
主要成果:
- 包括27,246名患者在内的15项研究符合纳入标准.
- CA-AKI的综合发病率为5.0% (95%CI,2.1%-8.9%) 和RRT为0.2% (95%CI,0.0%-0.4%). 这两种情况的发病率均为1.5% (95%CI,0.0%-0.4%).
- 糖尿病与CA-AKI率的增加有关 (P=0.002),而基线功能和对比体积并不是显著因素.
结论:
- 在AIS的EVT后,CA-AKI和RRT的发生率很低.
- 对功能的担忧不应阻碍符合条件的患者及时接受EVT.
- 进一步的研究可能会探索糖尿病患者的特定风险减轻策略.
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