在缺血性中风后,三年坚持二次预防和血管风险控制
Erlend Fagerli1, Hanne Ellekjær2,3, Olav Spigset4,5
1Department of Circulation and Medical Imaging, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.
European stroke journal
|January 30, 2026
概括
缺血性中风后三年,药物坚持度很高,但血管风险因素控制仍然很差. 对于挪威中风幸存者来说,需要加强二次预防策略,以改善长期结果.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 在缺血性中风后长期坚持二次预防策略至关重要,但并未得到充分理解.
- 评估药物坚持和实现血管治疗目标对于优化中风后护理至关重要.
- 了解影响目标实现的因素可以指导个性化的二次预防计划.
研究的目的:
- 在缺血性中风后3年评估药物坚持和持续性.
- 评估基于指南的血管治疗目标 (血压,LDL胆固醇,HbA1c) 的实现情况.
- 确定与实现这些二次预防目标相关的临床特征.
主要方法:
- 来自挪威脑卒中后认知障碍研究的431名住家缺血性中风患者的队列被跟踪了3年.
- 使用莫里斯基药物坚持度表和药物持续性来测量药物坚持度.
- 治疗目标包括血压<140/90 mmHg,LDL胆固醇<2.0 mmol/L,以及HbA1c ≤53 mmol/mol.
主要成果:
- 在3年后观察到高药物持续率 (97%的抗血栓剂,91%的抗高血压剂,83%的降脂药物).
- 尽管坚持度很高 (73%),但目标实现率不够理想:血压为42%,LDL胆固醇为47%.
- 年龄较小与更好的血压控制相关;女性性别与较差的LDL胆固醇控制.
结论:
- 风险因素控制仍然令人满意的3年后缺血性中风,尽管良好的药物坚持和持久性.
- 特定的患者特征会影响血管治疗目标的实现.
- 需要在挪威中风患者中更好地实施二次预防策略.
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