Lancet:Nerinetide用于缺血性脑卒中患者神经保护

2020-02-21 MedSci MedSci原创

神经保护剂Nerinetide不能改善血管内血栓切除术患者预后

Nerinetide是一种神经保护剂,可干扰突触后密度蛋白95(PSD-95),在临床前缺血性脑卒中模型中有效。近日,研究人员评估了Nerinetide在急性缺血性脑卒中患者血管血栓切除术中预防缺血再灌注不良事件的有效性和安全性。

成年的12小时治疗窗口内的大血管闭塞急性缺血性脑卒中患者参与研究。患者Alberta中风早期CT评分(ASPECTS)大于4,血管成像显示中度至良好侧支充盈,由多期CT确定血管造影。随机接受单次剂量为2.6 mg/kg的Nerinetide,最大剂量为270毫克或者接受生理盐水安慰剂。研究的主要终点是随机化90天后的功能预后良好,定义为修正的Rankin量表(MRS)评分为0-2分。次要终点是神经功能残疾、日常生活活动中的功能独立性、良好的功能结果(mRS 0-1)和死亡率。

1105例患者参与研究,其中Nerinetide组549人,安慰剂组556人。90天内mRS评分为0-2的患者比例如下:Nerinetide组337人(61.4%),安慰剂组329人(59.2%),校正风险比为1.04。两组间的次要结果相似。我们观察到在接受阿替普酶的患者中,Nerinetide治疗导致阿替普酶效果受抑制。两组间严重不良事件发生率相同。

研究认为,神经保护剂Nerinetide不能改善血管内血栓切除术患者预后。

原始出处:


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  1. 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    2021-09-14 病毒猎手

    NA-1是一种可以与突触后密度蛋白95相互作用的二十肽。在前期研究中科学家发现它可以有效减少猴模型中的缺血再灌注梗死体积,并改善其神经功能。   Michael D Hill本次报告的研究是名为ESCAPE-NA1的一项3期多中心、随机、双盲、安慰剂对照、平行组、单剂量设计的研究。这项研究确定了对AIS后行血管内血栓切除术(EVT)者静滴NA-1(2.6 mg/kg)的安全性以及神经保护有效性。   研究涉及加拿大、美国、爱尔兰、英国、瑞典、德国、韩国和澳大利亚8个国家的48个中心,纳入了12小时内因大血管闭塞导致的急性缺血性脑卒中患者1105名患者。患者被随机分为NA-1组(549人)和安慰剂组(556人),并根据静脉注射阿替普酶治疗和进行血管内治疗(EVT)进行分层。   主要终点为受试者发生AIS后90天内改良Rankin(mRS)评分0-2的人数比例,次要终点为90天时mRS和NIHSS评分变化。同时研究者以90天死亡率和严重不良事件作为安全性的评价标准。   研究结果表明,在NA-1组和安慰剂组患者中分别有337(61.4%)和329(59.2%)人达到了终点(调整后RR 为1.04,95% CI 0.96–1.14;P=0.35),差异无统计学意义;在次要终点上也无显著差异。   但进行分层后,研究者发现了非常有价值的结果:   在EVT组中,NA-1组和安慰剂组分别有59.3%和49.8%达到主要终点(调整后RR为1.18; 95% CI为 1.01-1.38),差异有统计学意义。对梗死体积的比较发现,接受EVT的病人中,NA-1组相比于安慰剂组,梗死体积减少的中位数是12.5ml;两组的不良事件没有显著性差异。   也就是说,在接受EVT的病人中,NA-1具有神经保护作用。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1051044, encodeId=91be10510441a, content=NA-1是一种可以与突触后密度蛋白95相互作用的二十肽。在前期研究中科学家发现它可以有效减少猴模型中的缺血再灌注梗死体积,并改善其神经功能。   Michael D Hill本次报告的研究是名为ESCAPE-NA1的一项3期多中心、随机、双盲、安慰剂对照、平行组、单剂量设计的研究。这项研究确定了对AIS后行血管内血栓切除术(EVT)者静滴NA-1(2.6 mg/kg)的安全性以及神经保护有效性。   研究涉及加拿大、美国、爱尔兰、英国、瑞典、德国、韩国和澳大利亚8个国家的48个中心,纳入了12小时内因大血管闭塞导致的急性缺血性脑卒中患者1105名患者。患者被随机分为NA-1组(549人)和安慰剂组(556人),并根据静脉注射阿替普酶治疗和进行血管内治疗(EVT)进行分层。   主要终点为受试者发生AIS后90天内改良Rankin(mRS)评分0-2的人数比例,次要终点为90天时mRS和NIHSS评分变化。同时研究者以90天死亡率和严重不良事件作为安全性的评价标准。   研究结果表明,在NA-1组和安慰剂组患者中分别有337(61.4%)和329(59.2%)人达到了终点(调整后RR 为1.04,95% CI 0.96–1.14;P=0.35),差异无统计学意义;在次要终点上也无显著差异。   但进行分层后,研究者发现了非常有价值的结果:   在EVT组中,NA-1组和安慰剂组分别有59.3%和49.8%达到主要终点(调整后RR为1.18; 95% CI为 1.01-1.38),差异有统计学意义。对梗死体积的比较发现,接受EVT的病人中,NA-1组相比于安慰剂组,梗死体积减少的中位数是12.5ml;两组的不良事件没有显著性差异。   也就是说,在接受EVT的病人中,NA-1具有神经保护作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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    2021-09-14 病毒猎手

    #缺血性卒中#第一个有效的神经保护剂问世,50年来首次!!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1051044, encodeId=91be10510441a, content=NA-1是一种可以与突触后密度蛋白95相互作用的二十肽。在前期研究中科学家发现它可以有效减少猴模型中的缺血再灌注梗死体积,并改善其神经功能。   Michael D Hill本次报告的研究是名为ESCAPE-NA1的一项3期多中心、随机、双盲、安慰剂对照、平行组、单剂量设计的研究。这项研究确定了对AIS后行血管内血栓切除术(EVT)者静滴NA-1(2.6 mg/kg)的安全性以及神经保护有效性。   研究涉及加拿大、美国、爱尔兰、英国、瑞典、德国、韩国和澳大利亚8个国家的48个中心,纳入了12小时内因大血管闭塞导致的急性缺血性脑卒中患者1105名患者。患者被随机分为NA-1组(549人)和安慰剂组(556人),并根据静脉注射阿替普酶治疗和进行血管内治疗(EVT)进行分层。   主要终点为受试者发生AIS后90天内改良Rankin(mRS)评分0-2的人数比例,次要终点为90天时mRS和NIHSS评分变化。同时研究者以90天死亡率和严重不良事件作为安全性的评价标准。   研究结果表明,在NA-1组和安慰剂组患者中分别有337(61.4%)和329(59.2%)人达到了终点(调整后RR 为1.04,95% CI 0.96–1.14;P=0.35),差异无统计学意义;在次要终点上也无显著差异。   但进行分层后,研究者发现了非常有价值的结果:   在EVT组中,NA-1组和安慰剂组分别有59.3%和49.8%达到主要终点(调整后RR为1.18; 95% CI为 1.01-1.38),差异有统计学意义。对梗死体积的比较发现,接受EVT的病人中,NA-1组相比于安慰剂组,梗死体积减少的中位数是12.5ml;两组的不良事件没有显著性差异。   也就是说,在接受EVT的病人中,NA-1具有神经保护作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Sep 14 10:42:10 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051042, encodeId=31d81051042e1, content=<a href='/topic/show?id=fa10e93597f' target=_blank style='color:#2F92EE;'>#缺血性卒中#</a>第一个有效的神经保护剂问世,50年来首次!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79359, encryptionId=fa10e93597f, topicName=缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Sep 14 10:41:20 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051041, 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    2021-09-14 病毒猎手

    #Nerinetide#这是50年来首个#神经保护剂#,真正看到阳性结果的!!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1051044, encodeId=91be10510441a, content=NA-1是一种可以与突触后密度蛋白95相互作用的二十肽。在前期研究中科学家发现它可以有效减少猴模型中的缺血再灌注梗死体积,并改善其神经功能。   Michael D Hill本次报告的研究是名为ESCAPE-NA1的一项3期多中心、随机、双盲、安慰剂对照、平行组、单剂量设计的研究。这项研究确定了对AIS后行血管内血栓切除术(EVT)者静滴NA-1(2.6 mg/kg)的安全性以及神经保护有效性。   研究涉及加拿大、美国、爱尔兰、英国、瑞典、德国、韩国和澳大利亚8个国家的48个中心,纳入了12小时内因大血管闭塞导致的急性缺血性脑卒中患者1105名患者。患者被随机分为NA-1组(549人)和安慰剂组(556人),并根据静脉注射阿替普酶治疗和进行血管内治疗(EVT)进行分层。   主要终点为受试者发生AIS后90天内改良Rankin(mRS)评分0-2的人数比例,次要终点为90天时mRS和NIHSS评分变化。同时研究者以90天死亡率和严重不良事件作为安全性的评价标准。   研究结果表明,在NA-1组和安慰剂组患者中分别有337(61.4%)和329(59.2%)人达到了终点(调整后RR 为1.04,95% CI 0.96–1.14;P=0.35),差异无统计学意义;在次要终点上也无显著差异。   但进行分层后,研究者发现了非常有价值的结果:   在EVT组中,NA-1组和安慰剂组分别有59.3%和49.8%达到主要终点(调整后RR为1.18; 95% CI为 1.01-1.38),差异有统计学意义。对梗死体积的比较发现,接受EVT的病人中,NA-1组相比于安慰剂组,梗死体积减少的中位数是12.5ml;两组的不良事件没有显著性差异。   也就是说,在接受EVT的病人中,NA-1具有神经保护作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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  5. 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  6. 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    2021-01-15 howi
  7. [GetPortalCommentsPageByObjectIdResponse(id=1051044, encodeId=91be10510441a, content=NA-1是一种可以与突触后密度蛋白95相互作用的二十肽。在前期研究中科学家发现它可以有效减少猴模型中的缺血再灌注梗死体积,并改善其神经功能。   Michael D Hill本次报告的研究是名为ESCAPE-NA1的一项3期多中心、随机、双盲、安慰剂对照、平行组、单剂量设计的研究。这项研究确定了对AIS后行血管内血栓切除术(EVT)者静滴NA-1(2.6 mg/kg)的安全性以及神经保护有效性。   研究涉及加拿大、美国、爱尔兰、英国、瑞典、德国、韩国和澳大利亚8个国家的48个中心,纳入了12小时内因大血管闭塞导致的急性缺血性脑卒中患者1105名患者。患者被随机分为NA-1组(549人)和安慰剂组(556人),并根据静脉注射阿替普酶治疗和进行血管内治疗(EVT)进行分层。   主要终点为受试者发生AIS后90天内改良Rankin(mRS)评分0-2的人数比例,次要终点为90天时mRS和NIHSS评分变化。同时研究者以90天死亡率和严重不良事件作为安全性的评价标准。   研究结果表明,在NA-1组和安慰剂组患者中分别有337(61.4%)和329(59.2%)人达到了终点(调整后RR 为1.04,95% CI 0.96–1.14;P=0.35),差异无统计学意义;在次要终点上也无显著差异。   但进行分层后,研究者发现了非常有价值的结果:   在EVT组中,NA-1组和安慰剂组分别有59.3%和49.8%达到主要终点(调整后RR为1.18; 95% CI为 1.01-1.38),差异有统计学意义。对梗死体积的比较发现,接受EVT的病人中,NA-1组相比于安慰剂组,梗死体积减少的中位数是12.5ml;两组的不良事件没有显著性差异。   也就是说,在接受EVT的病人中,NA-1具有神经保护作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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encodeId=afd2105104127, content=<a href='/topic/show?id=5de01266383' target=_blank style='color:#2F92EE;'>#Nerinetide#</a>这是50年来首个<a href='/topic/show?id=f51fe4158e6' target=_blank style='color:#2F92EE;'>#神经保护剂#</a>,真正看到阳性结果的!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12663, encryptionId=5de01266383, topicName=Nerinetide), TopicDto(id=74158, encryptionId=f51fe4158e6, topicName=神经保护剂)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Sep 14 10:40:42 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893266, encodeId=1eb9189326622, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Sep 29 02:03:00 CST 2020, time=2020-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1679141, encodeId=bcc516e9141b5, content=<a href='/topic/show?id=7a2684e600b' target=_blank style='color:#2F92EE;'>#脑卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84760, encryptionId=7a2684e600b, topicName=脑卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=091e27733095, createdName=weihongyv, createdTime=Mon Mar 09 11:03:00 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830484, encodeId=92f01830484b8, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Jan 15 09:03:00 CST 2021, time=2021-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734209, encodeId=c29c1e3420968, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Wed Mar 25 10:03:00 CST 2020, time=2020-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807129, encodeId=dcdc180e12978, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Thu Sep 03 03:03:00 CST 2020, time=2020-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720326, encodeId=35771e2032681, 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=33, 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=Fri Jan 01 10:03:00 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361766, encodeId=948a1361e66a9, content=<a href='/topic/show?id=0a9de4156d4' target=_blank style='color:#2F92EE;'>#神经保护#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74156, encryptionId=0a9de4156d4, topicName=神经保护)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0ad8182, createdName=axin009, createdTime=Sun Feb 23 10:03:00 CST 2020, time=2020-02-23, status=1, ipAttribution=)]
    2020-03-25 canlab
  8. [GetPortalCommentsPageByObjectIdResponse(id=1051044, encodeId=91be10510441a, content=NA-1是一种可以与突触后密度蛋白95相互作用的二十肽。在前期研究中科学家发现它可以有效减少猴模型中的缺血再灌注梗死体积,并改善其神经功能。   Michael D Hill本次报告的研究是名为ESCAPE-NA1的一项3期多中心、随机、双盲、安慰剂对照、平行组、单剂量设计的研究。这项研究确定了对AIS后行血管内血栓切除术(EVT)者静滴NA-1(2.6 mg/kg)的安全性以及神经保护有效性。   研究涉及加拿大、美国、爱尔兰、英国、瑞典、德国、韩国和澳大利亚8个国家的48个中心,纳入了12小时内因大血管闭塞导致的急性缺血性脑卒中患者1105名患者。患者被随机分为NA-1组(549人)和安慰剂组(556人),并根据静脉注射阿替普酶治疗和进行血管内治疗(EVT)进行分层。   主要终点为受试者发生AIS后90天内改良Rankin(mRS)评分0-2的人数比例,次要终点为90天时mRS和NIHSS评分变化。同时研究者以90天死亡率和严重不良事件作为安全性的评价标准。   研究结果表明,在NA-1组和安慰剂组患者中分别有337(61.4%)和329(59.2%)人达到了终点(调整后RR 为1.04,95% CI 0.96–1.14;P=0.35),差异无统计学意义;在次要终点上也无显著差异。   但进行分层后,研究者发现了非常有价值的结果:   在EVT组中,NA-1组和安慰剂组分别有59.3%和49.8%达到主要终点(调整后RR为1.18; 95% CI为 1.01-1.38),差异有统计学意义。对梗死体积的比较发现,接受EVT的病人中,NA-1组相比于安慰剂组,梗死体积减少的中位数是12.5ml;两组的不良事件没有显著性差异。   也就是说,在接受EVT的病人中,NA-1具有神经保护作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Sep 14 10:42:10 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051042, encodeId=31d81051042e1, content=<a href='/topic/show?id=fa10e93597f' target=_blank style='color:#2F92EE;'>#缺血性卒中#</a>第一个有效的神经保护剂问世,50年来首次!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79359, encryptionId=fa10e93597f, topicName=缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Sep 14 10:41:20 CST 2021, time=2021-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1051041, 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  9. [GetPortalCommentsPageByObjectIdResponse(id=1051044, encodeId=91be10510441a, content=NA-1是一种可以与突触后密度蛋白95相互作用的二十肽。在前期研究中科学家发现它可以有效减少猴模型中的缺血再灌注梗死体积,并改善其神经功能。   Michael D Hill本次报告的研究是名为ESCAPE-NA1的一项3期多中心、随机、双盲、安慰剂对照、平行组、单剂量设计的研究。这项研究确定了对AIS后行血管内血栓切除术(EVT)者静滴NA-1(2.6 mg/kg)的安全性以及神经保护有效性。   研究涉及加拿大、美国、爱尔兰、英国、瑞典、德国、韩国和澳大利亚8个国家的48个中心,纳入了12小时内因大血管闭塞导致的急性缺血性脑卒中患者1105名患者。患者被随机分为NA-1组(549人)和安慰剂组(556人),并根据静脉注射阿替普酶治疗和进行血管内治疗(EVT)进行分层。   主要终点为受试者发生AIS后90天内改良Rankin(mRS)评分0-2的人数比例,次要终点为90天时mRS和NIHSS评分变化。同时研究者以90天死亡率和严重不良事件作为安全性的评价标准。   研究结果表明,在NA-1组和安慰剂组患者中分别有337(61.4%)和329(59.2%)人达到了终点(调整后RR 为1.04,95% CI 0.96–1.14;P=0.35),差异无统计学意义;在次要终点上也无显著差异。   但进行分层后,研究者发现了非常有价值的结果:   在EVT组中,NA-1组和安慰剂组分别有59.3%和49.8%达到主要终点(调整后RR为1.18; 95% CI为 1.01-1.38),差异有统计学意义。对梗死体积的比较发现,接受EVT的病人中,NA-1组相比于安慰剂组,梗死体积减少的中位数是12.5ml;两组的不良事件没有显著性差异。   也就是说,在接受EVT的病人中,NA-1具有神经保护作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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  10. 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