Stroke:急性缺血性脑卒中患者入院血糖及对动脉内治疗效果影响的分析!

2017-04-10 xing.T MedSci原创

由此可见,该研究未发现急性缺血性脑卒中患者入院时血糖水平对动脉内治疗效果具有影响。

缺血性卒中后入院时高血糖较为常见,其与静脉溶栓治疗与动脉内治疗后不良结局相关。然而,高血糖是否会影响再灌注治疗的效果尚不明确。近日,卒中领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在评估入院时血糖升高是否会影响急性缺血性卒中患者动脉内治疗的效果。

研究人员采用荷兰急性缺血性卒中血管内治疗多中心随机对照试验(MR CLEAN研究)的数据。高血糖定义为入院时血糖大于7.8mmol/L。该研究的主要结局指标为90天改良Rankin量表得分朝结局较好方向转变的调整后比值比,经常规Logistic回归来估计。该研究次要结局变量为症状性颅内出血。研究人员采用了倍增的相互作用的因素和调整预后变量评估了调节高血糖的治疗效果和入院时血糖水平。

该研究纳入了487例患者。平均入院血糖为7.2 mmol/L(SD为2.2)。226例被随机分为动脉内介入治疗的患者中有57例(25%)患者为高血糖,在对照组261例的患者中有61例(23%)患者为高血糖。研究人员发现高血糖或入院时血糖水平均与治疗对改良Rankin量表评分的影响之间的相互作用并不显著(分别有P=0.67和P=0.87)。同样适用于症状性脑出血的发生(高血糖P=0.39,入院血糖水平P=0.39)。

由此可见,该研究未发现急性缺血性脑卒中患者入院时血糖水平对动脉内治疗效果具有影响。

原始出处:

Elizabeth Osei, et al. Admission Glucose and Effect of Intra-Arterial Treatment in Patients With Acute Ischemic Stroke.Stroke. 2017. https://doi.org/10.1161/STROKEAHA.116.016071

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    2017-04-10 knowheart

    缺血性卒中后入院时高血糖较为常见,其与静脉溶栓治疗与动脉内治疗后不良结局相关。

    0

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JAHA:急性缺血性脑卒中患者语言偏好与静脉溶栓的关系

结论与研究假设相反,一旦考虑初始卒中严重程度,在急性缺血性卒中患者中偏好说非英语语言与较低的静脉溶栓率无关。

Neurology:急性缺血性脑卒中患者入院高血糖可以预测脑卒中后感染!

由此可见,在非糖尿病急性缺血性脑卒中患者中,入院高血糖与脑卒中后感染与预后较差相关。脑卒中后感染并没有改变入院高血糖对缺血性脑卒中患者功能预后的影响。

NEJM:急性缺血性脑卒中,低剂量阿替普酶的治疗效果并不差于标准剂量

NEJM:急性缺血性脑卒中,低剂量阿替普酶的治疗效果并不差于标准剂量的治疗效果使用低于标准剂量的阿替普酶对急性缺血性脑卒中进行溶栓治疗可以改善脑出血的结局,还可降低脑出血的风险。采用2*2准因子开放标签设计,随机分配了3310名符合溶栓治疗的患者(中位年龄为67岁; 63%为亚洲人),分别接受低剂量的阿替普酶治疗(0.6 mg/kg)和标准剂量治疗(0.9 mg/kg);随机分组是在患者急性缺血性

Stroke:急性缺血性脑卒中患者**嗜酸性粒细胞计数和复杂主动脉弓斑块有啥关系?

由此可见,在急性缺血性脑卒中患者中,血液中绝对嗜酸性粒细胞计数的增加与复杂主动脉弓斑块的存在独立相关。该研究的结果表明血液中绝对嗜酸性粒细胞计数可能是急性缺血性脑卒中患者存在复杂主动脉弓斑块的一个有用的预测因素。