Neurology:卒中患者想要获得好预后,血管内治疗开始时间很重要

2021-01-05 MedSci原创 MedSci原创

对于AIS患者,早上开始EVT可以改善中期功能,而在下班时段进行EVT可以降低患者中期功能预后。

近日,神经病学领域权威杂志Neurology上发表了一篇研究文章,该研究旨在探讨急性缺血性卒中(EVS)患者血管内治疗(EVT)开始时间与中期功能预后之间的关系。

这项回顾性队列研究纳入了2012年1月至2018年12月期间来自两个卒中中心登记处的所有接受EVT治疗的AIS病例。该研究的主要结局为90天时改良的Rankin量表(mRS)和效用加权的mRS(uw-mRS)评分。比例比值模型用于计算比值比,以衡量在给定的EVT开始时间进行干预会导致mRS评分分较低的可能性。

158名患者被平均分配给12个时间段开始EVT。该研究的主要结果支持开始EVT的最佳时间为早上08:00-10:20和10:20-11:34(分别有比值比(OR)为0.53; 95%置信区间(CI)为0.38至0.75;P<0.001;OR为0.62;95%CI为0.44至0.87;P=0.006),但效果不佳的EVT开始时间为15:55-17:15和18:55-20:55(分别有OR为1.47;95%CI为1.03至2.09;P=0.034;OR为1.49;95%CI为1.03至2.15;P=0.033)。在10:20-11:34之间,症状发作至EVT的开始时间明显更长,而使用t-PA静脉溶栓则明显更低(分别为P<0.004和P=0.012)。

由此可见,对于AIS患者,早上开始EVT可以改善中期功能,而在下班时段进行EVT可以降低患者中期功能预后。

原始出处:

Steven D Hajdu.et al.Association of Time of Day When Endovascular Therapy for Stroke Starts and Functional Outcome.Neurology.2021.https://doi.org/10.1212/WNL.0000000000011449

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1720363, encodeId=f2b51e2036339, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Sun Apr 18 23:12:02 CST 2021, time=2021-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956462, encodeId=c05395646270, content=原文是1558例患者, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39d5080466, createdName=1690024190_79993671, createdTime=Tue Apr 13 09:41:09 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001192, encodeId=513020011924f, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Jun 21 01:12:02 CST 2021, time=2021-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=914775, encodeId=b64c914e7595, content=get了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28515451273, createdName=thrase, createdTime=Sat Jan 09 00:12:16 CST 2021, time=2021-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026742, encodeId=8f7e1026e4270, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Jan 06 02:12:02 CST 2021, time=2021-01-06, status=1, ipAttribution=)]
    2021-04-13 1690024190_79993671

    原文是1558例患者

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1720363, encodeId=f2b51e2036339, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Sun Apr 18 23:12:02 CST 2021, time=2021-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956462, encodeId=c05395646270, content=原文是1558例患者, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39d5080466, createdName=1690024190_79993671, createdTime=Tue Apr 13 09:41:09 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001192, encodeId=513020011924f, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Jun 21 01:12:02 CST 2021, time=2021-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=914775, encodeId=b64c914e7595, content=get了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28515451273, createdName=thrase, createdTime=Sat Jan 09 00:12:16 CST 2021, time=2021-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026742, encodeId=8f7e1026e4270, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Jan 06 02:12:02 CST 2021, time=2021-01-06, status=1, ipAttribution=)]
    2021-06-21 yinhl1978
  4. [GetPortalCommentsPageByObjectIdResponse(id=1720363, encodeId=f2b51e2036339, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Sun Apr 18 23:12:02 CST 2021, time=2021-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956462, encodeId=c05395646270, content=原文是1558例患者, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39d5080466, createdName=1690024190_79993671, createdTime=Tue Apr 13 09:41:09 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001192, encodeId=513020011924f, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Jun 21 01:12:02 CST 2021, time=2021-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=914775, encodeId=b64c914e7595, content=get了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28515451273, createdName=thrase, createdTime=Sat Jan 09 00:12:16 CST 2021, time=2021-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026742, encodeId=8f7e1026e4270, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Jan 06 02:12:02 CST 2021, time=2021-01-06, status=1, ipAttribution=)]
    2021-01-09 thrase

    get了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1720363, encodeId=f2b51e2036339, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Sun Apr 18 23:12:02 CST 2021, time=2021-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956462, encodeId=c05395646270, content=原文是1558例患者, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39d5080466, createdName=1690024190_79993671, createdTime=Tue Apr 13 09:41:09 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001192, encodeId=513020011924f, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Jun 21 01:12:02 CST 2021, time=2021-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=914775, encodeId=b64c914e7595, content=get了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28515451273, createdName=thrase, createdTime=Sat Jan 09 00:12:16 CST 2021, time=2021-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026742, encodeId=8f7e1026e4270, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Jan 06 02:12:02 CST 2021, time=2021-01-06, status=1, ipAttribution=)]
    2021-01-06 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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