在急性缺血性中风患者中进行内血管治疗,并具有前中风残疾:系统性审查和元分析
Lucca Tamara Alves Carretta1, Mariana Letícia de Bastos Maximiano2, Rudolfh Batista Arend3
1Department of Medicine, Escola Suérior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Vitória, Brazil.
The neuroradiology journal
|February 11, 2026
概括
内血管血栓切除术 (EVT) 改善了急性缺血性中风 (AIS) 患者的生存率和功能恢复,这些患者在中风前有残疾. 这种治疗提供了好处,但没有显著增加症状内出血的风险.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
- 公共卫生 公共卫生
背景情况:
- 患有中风前残疾 (mRS>2) 的急性缺血性中风 (AIS) 患者通常被排除在临床试验之外.
- 最好的医疗治疗 (BMT) 是这些患者的标准,但它的局限性是公认的.
研究的目的:
- 为了评估内血管血栓切除术 (EVT) 的疗效和安全性,与AIS患者中AIS患者中BMT相比.
- 评估包括死亡率,功能恢复和症状性内出血 (sICH) 在内的结果.
主要方法:
- 根据PRISMA 2020指南进行的元分析.
- 从创立到2025年7月,对主要数据库 (PubMed,Cochrane,科学网,Scopus,Embase) 的系统搜索.
- 包括5项研究 (1400名患者),比较EVT与BMT在中风前mRS 2-4.4患者中.
主要成果:
- EVT显著降低了所有原因的死亡率 (OR:0.49,95% CI:0.29-0.82,p = .007).
- EVT改善了基线的回归,修改了兰金度量 (mRS) (OR:3.21,95% CI:2.02-6.09,p <.001).
- 症状性内出血 (sICH) 在EVT中更频繁,但没有统计学意义 (OR:2.24,95%CI:0.84-5.94,p = .11).
结论:
- 血管内血栓切除术为中风前残疾的AIS患者提供了显著的生存益处.
- 在这种患者群体中,EVT提高了对基线状态的功能恢复.
- 需要进行进一步的前性研究,以指导包括性临床指导方针,以对前脑卒中残疾的AIS进行EVT.
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