Stroke:依达拉奉对急性缺血性脑卒中患者神经症状的影响

2019-06-07 xing.T 网络

由此可见,对于任何缺血性卒中亚型,依达拉奉的使用(与不使用相比)与神经症状的改善有关,尽管差异很小(NIHSS<1分)且临床意义有限。

在日本,近一半的缺血性卒中患者接受依达拉奉用于急性治疗。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,该研究的目的是评估依达拉奉对缺血性卒中患者神经系统症状的影响。

研究对象为61048名18岁或以上的患者,他们在急性缺血性卒中发病后≤14天住院,并于2001年6月至2013年7月在日本卒中数据库(一家基于医院的多中心卒中登记数据库)登记。根据缺血性卒中亚型(大动脉粥样硬化、心源性栓塞、小血管闭塞和隐源性/未确定)对患者进行分层,然后分为2组(依达拉奉治疗组和非依达拉奉组)。研究人员使用美国国立卫生研究院卒中量表(NIHSS)评估神经症状。在住院期间,主要结局为神经系统症状方面发生的改变(ΔNIHSS=出院时的NIHSS评分-入院时的NIHSS评分)。在调整混杂因素后,使用多变量线性回归分析数据,并对治疗加权的反向概率进行分析,这些混杂因素包括:治疗开始时的年龄、性别、收缩压和舒张压、入院时的NIHSS评分、卒中发病至住院的时间、梗塞面积、合并症、伴随药物、临床科室、吸烟史、饮酒史和卒中史。 

在调整潜在的混杂因素后,依达拉奉治疗组入院至出院时NIHSS评分的改善程度高于非依达拉奉治疗组(所有缺血性卒中亚型)(对于大动脉粥样硬化ΔNIHSS的平均[95%CI]差异:-0.46[-0.75]),对于心血管栓塞为-0.64 [-1.09至-0.2],对于小血管闭塞为-0.25 [-0.4至-0.09])。 

由此可见,对于任何缺血性卒中亚型,依达拉奉的使用(与不使用相比)与神经症状的改善有关,尽管差异很小(NIHSS<1分)且临床意义有限。 

原始出处:

Susumu Kobayashi.et al.Effect of Edaravone on Neurological Symptoms in Real-World Patients With Acute Ischemic Stroke Japan Stroke Data Bank.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.024351

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    2019-06-07 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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依达拉奉对早期ALS患者表现出较好的疗效,可以有效减缓早期肌萎缩侧索硬化病情发展

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静脉输入依达拉奉的时间并不影响组织型纤溶酶原激活剂治疗后的早期再通率、症状性脑出血或有利结局。