Stroke:动脉瘤性蛛网膜下腔出血患者的抗精神病药物使用情况分析

2019-06-07 xing.T 网络

由此可见,aSAH后12个月幸存者在aSAH后开始接受APD治疗的可能性明显高于匹配的人群对照者。这些患者经常同时使用抗抑郁药和抗癫痫药。APA的使用与aSAH后脑损伤的迹象密切相关,如果没有显著的脑损伤迹象,则使用率低。

在急性期和神经重症监护中,动脉瘤性蛛网膜下腔出血(aSAH)患者可能会变得激动或神志不清。研究人员没有发现以前对长期aSAH幸存者使用精神病或抗精神病药物(APD)的研究。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员在一项东部芬兰人群为基础的队列研究中,对长期随访的超过12个月的aSAH幸存者确定了APD使用及其危险因素。

研究人员分析了1144名连续就诊的aSAH患者的APD使用情况,这些患者在Kuopio颅内动脉瘤患者和家庭数据库进行登记,并存活12个月,根据他们的年龄、性别和出生自治市匹配的对照者(3:1; n=3432),从1995年到2013年,中位随访9年。研究人员使用Finish全国健康登记处,获得了药物购买和出院数据。

总共有1144名患者中的140名(12%)在aSAH后第一次开始使用APD,而3432名匹配的人群对照组中有145名(4%)。起始APD的累积率在1年时为6%,在5年时为9%,而对照组分别为1%和2%。在489名状况良好的患者中,1年和5年的比率仅为1%和2%(改良Rankin量表评分,12个月时为0或1;无分流、脑内出血或脑室内出血)。相反,在aSAH后分流为脑积水的192例患者中APA使用率最高,5年时为23%。使用APD的140名aSAH患者中有88名(63%)也同时使用抗抑郁药或抗癫痫药。

由此可见,aSAH后12个月幸存者在aSAH后开始接受APD治疗的可能性明显高于匹配的人群对照者。这些患者经常同时使用抗抑郁药和抗癫痫药。APA的使用与aSAH后脑损伤的迹象密切相关,如果没有显著的脑损伤迹象,则使用率低。
 
原始出处:

Juho T. Paavola.et al.Antipsychotic Use Among 1144 Patients After Aneurysmal Subarachnoid Hemorrhage A Population-Based Case-Control Study.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.024914

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    2019-06-07 orangesking

    0

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    2019-06-07 医者仁心5538

    学习了

    0

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在BAV引起的TAA患者中,主动脉僵硬度和脉动动脉负荷增加提示与动脉瘤的扩张加速有关。

颅内动脉瘤主瘤腔血栓形成载子囊破裂1例

女,52岁,因突发头痛3 h入院。术前Hunt-Hess分级2级。急诊头颅CT示:鞍上池及右侧环池积血、广泛蛛网膜下腔出血、右额叶血肿(图1A、1B)。发病后10 h头颅CTA检查未见确切动脉瘤征象(图1C)。发病24 h 2D-DSA检查发现右侧胼缘动脉额中内侧分支一微小动脉瘤,大小约1 mm×1.5 mm,余血管造影均未见异常(图1D)。因条件限制未行3D-DSA及旋转重建。

手术切除颅内多发黏液性动脉瘤一例

患者女,58岁,因“体检发现颅内动脉瘤2年”于2015年10月26日收入第二军医大学附属长海医院神经外科。入院前2年头部MRI显示右额叶高信号,当地医院考虑海绵状血管瘤,给予保守治疗。1年前行心房黏液瘤切除术,围手术期查头部MR血管成像示右侧大脑前动脉、大脑中动脉各有1个梭形动脉瘤。为进一步治疗入住第二军医大学附属长海医院。