Stroke:急性缺血性卒中不同亚型的降压治疗效果

2015-02-12 李志行 译 MedSci原创

斯堪的纳维亚坎地沙坦急性卒中试验(SCAST)发现应用坎地沙坦为急性卒中患者进行降压治疗并不能使其获益。我们调查了不同缺血性脑卒中亚型的治疗效果是否存在不同。研究方法:SCAST是一随机化安慰剂对照试验,对缺血性或出血性脑卒中发作30小时内,收缩压≥140 mm Hg的2029名患者进行坎地沙坦试验。根据牛津郡社区脑卒中项目分类对缺血性脑卒中亚型进行分类。存有两个初始效应变量:前6个月内发生血管性

斯堪的纳维亚坎地沙坦急性卒中试验(SCAST)发现应用坎地沙坦为急性卒中患者进行降压治疗并不能使其获益。我们调查了不同缺血性脑卒中亚型的治疗效果是否存在不同。

研究方法:


SCAST是一随机化安慰剂对照试验,对缺血性或出血性脑卒中发作30小时内,收缩压≥140 mm Hg的2029名患者进行坎地沙坦试验。根据牛津郡社区脑卒中项目分类对缺血性脑卒中亚型进行分类。存有两个初始效应变量:前6个月内发生血管性死亡、心肌梗死或卒中的血管复合终点,以及6个月时的功能结局。



研究结果:

共包含1733名缺血性脑卒中患者:129名全前循环梗死,850名部分前循环梗死,236名后循环梗死,510名腔隙性梗死。在功能结局方面,与梗死面积较小(腔隙性脑梗死;P=0.02)的患者相比,坎地沙坦在梗死面积较大(全前循环梗死或部分前循环梗死)的患者中呈现出一种效果更好的大趋势。在血管复合终点方面,治疗效果没有差异。


(点击可放大)

研究结论:

研究结果显示应用坎地沙坦进行降压治疗的效果可能根据急性缺血性脑卒中类型的不同而不同,但这需要在未来的试验中得到证实。

Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00120003.

原始出处:

Else Charlotte Sandset, Mirza Jusufovic, Per Morten Sandset, Philip M.W. Bath, and Eivind Berge , on behalf of the SCAST Study Group
Effects of Blood Pressure–Lowering Treatment in Different Subtypes of Acute Ischemic Stroke
Stroke 2015; first published on February 5 2015 as doi:10.1161/STROKEAHA.114.008512

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    2015-02-16 windmilL1989

    0

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