Neurology:自发性脑出血患者他汀类药物与出血性水肿

2019-02-10 xing.T MedSci原创

由此可见,入院前使用他汀类药物治疗ICH与入院时rPHE降低无关。在未来的研究中,需要控制相对于ICH发作的影像学检查时间,以免受到混淆。

近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员旨在验证一个假设即自发性脑出血(ICH)患者入院时CT扫描(aCT)的出血性水肿与血肿比率(rPHE)不受家庭服用他汀类药物的影响,从症状发作到aCT的时间作为对照。

在176名连续就诊的ICH患者单中心前瞻性队列中,2名研究者使用半自动验证软件独立确定血肿和出血性水肿(PHE)的体积。rPHE以中位比率(>0.75 vs. ≤0.75)进行二分法。研究人员使用二元Logistic回归来评估他汀类药物与rPHE之间的关联。

在入院前使用他汀类药物作为家庭用药的患者(n=38)与未使用他汀类药物的患者(n=138)相比,中位数PHE体积为15.8 mL(四分位数范围[IQR]为6.5-39.4) vs. 10.8mL(IQR为5.1-26.8),p=0.2。 rPHE为0.71(IQR为0.56-1.0)vs. 0.74(IQR为0.52-1.0),p=0.79。在二元Logistic回归模型中,aCT相对于症状发作的时间(优势比[OR]为1.02,置信区间[CI]为1.01-1.12,p=0.016)和aCT上存在脑室内出血(OR为0.40,CI为0.20-0.78,p=0.007),而不是之前使用他汀类药物(OR为1.17,CI为0.55-2.52,p=0.68)与rPHE相关。

由此可见,入院前使用他汀类药物治疗ICH与入院时rPHE降低无关。在未来的研究中,需要控制相对于ICH发作的影像学检查时间,以免受到混淆。

原始出处:

Jens Witsch,et al.Statins and perihemorrhagic edema in patients with spontaneous intracerebral hemorrhage.Neurology. 2019.https://doi.org/10.1212/WNL.0000000000006931

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    2019-04-05 yinhl1978
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    2019-02-12 小华子
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    2019-02-12 sodoo

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美国心脏病协会/美国卒中协会(AHA/ASA)发布了关于自发性脑出血(ICH)诊断和治疗的最新指南。指南在线发表在5月29日《Stroke》杂志上。这份30页的文件提出了全面的急性ICH患者护理的循证指南,包括诊断、凝血障碍和血压管理、继发性脑损伤预防和颅内血压控制、手术作用、预后的预测、康复、二级预防及对未来的思考。I类推荐如下:急诊诊断和评估•进行基线严重性评分,作为ICH患者初始评估的一部分

Stroke:自发性脑出血患者超急性期血压变异性与患者结局之间的相关性!

由此可见,在发病后第一分钟和第一小时内的超急性脑出血患者的BPV与不良预后存在独立相关性。在院前和急救早期这个易损阶段维持BPV稳定是未来临床试验的潜在治疗靶点。

BMC Neurol:生物标记物增加预测自发性脑出血患者预后的准确性

背景:许多研究报道了颅内出血(ICH)生物标记物的预测预后的价值,但是这些生物标记物正处于研究阶段或者不如临床或者神经影像学的数据更具有效力。目的:检测生物标记物是否能显著增加预测ICH患者预后的准确性。方法:在多中心前瞻性队列研究中,共招募发生ICH72h内患者1020名。获得患者或其代理人的书面知情同意书后,取静脉血10mL,检测C反应蛋白(CRP)水平,S100B,神经胶质元酸性蛋白(GFA