JAHA:急性缺血性脑卒中患者语言偏好与静脉溶栓的关系

2016-11-29 haofan MedSci原创

结论与研究假设相反,一旦考虑初始卒中严重程度,在急性缺血性卒中患者中偏好说非英语语言与较低的静脉溶栓率无关。

研究表明约有20%的美国人在家里主要讲英语以外的其他语种。然而,在急性缺血性卒中的治疗中语言偏好对这类患者的影响尚未有研究报道。近日,心血管病领域权威杂志JAHA上发表了来自于美国波士顿哈佛医学院的Betty Luan Erfe博士及其研究团队的文章,旨在评估语言偏好对急性缺血性卒中患者接受静脉溶栓治疗的影响。

在项目中,研究人员对3894例急性缺血性卒中患者进行了分析,这些患者参加了美国心脏协会的“获得指南®卒中”计划,该计划于2003年1月1日到2014年4月30日期间在研究人员所在医疗机构进行。研究人员收集的信息包括患者所偏好的语言以及他们接受的医疗护理措施,调整相关的协变量后,并采用描述性统计方法和逐步Logistic回归模型来评估患者的语言偏好和接受静脉溶栓治疗之间的相关性。

该研究共有306/3295(9.3%)例急性缺血性卒中患者偏好说非英语语言,共主要有25种不同的非英语语言。调整了其他社会经济因素的多变量,分析发现偏好说非英语语言的患者比偏好说英语的患者接受静脉溶栓治疗的可能性更大(比值比为1.64;95%可信区间为1.09-2.48;P=0.02)。然而,在包括年龄、性别和初始NIH卒中量表的模型中,患者语言偏好不再显著(比值比为1.38;95%可信区间为0.88-2.15;P=0.16),但NIH卒中量表与患者接受静脉溶栓密切相关(每增加一分的比值比为1.15;95%可信区间为1.13-1.16;P<0.0001)。

由此可见,结论与研究假设相反,一旦考虑初始卒中严重程度,在急性缺血性卒中患者中偏好说非英语语言与较低的静脉溶栓率无关。

原始出处:

Betty Luan Erfe, et al. Relationship Between Language Preference and Intravenous Thrombolysis Among Acute Ischemic Stroke PatientsJAHA.November 23, 2016.


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    2017-01-21 fusion
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    2016-12-01 yangjxjc

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关于血管内治疗的试验研究其效果各异,而且需要进一步的定义亚组之间血管内介入治疗的效果。本研究旨在探究急性缺血性脑卒中患者血管内机械性取栓与临床结果之间的关系。

Stroke:急性缺血性脑卒中患者的总同型半胱氨酸水平升高与长期死亡率相关

在中风的急性期tHcy水平是否导致心脑血管事件的复发和死亡率事件发生。    该研究共招募了3799例因急性缺血性卒中而入院的患者。tHcy水平在入院后24小时内进行测量。中位随访时间为48个月。    在随访期间,233例(6.1%)患者死亡。在调整了年龄,吸烟状况,糖尿病和其他心血管危险因素后,与最低四分位数患者(≤10微摩尔/升)相

Stroke:急性缺血性脑卒中患者血小板的反应性随阿司匹林变化的临床意义

    目前研究已经发现冠状动脉疾病患者的血小板反应是岁时间而变化的。因此,研究人员试图评估在缺血性中风后的急性期血小板对阿司匹林应答的时间依赖性变化以及不同患者在急性缺血性中风中对阿司匹林的应答。    研究人员进行了一项单中心,前瞻性观察研究。急性阿司匹林反应单位(ARU)在服用阿司匹林3小时后进行测定,数值越高,表示血小板反应性增加。后续的ARU在连续