Neurology:常压高氧联合血管内治疗急性缺血性脑卒中的随机对照临床研究

2022-08-05 Naomi MedSci原创

近日,一项发表在Neurology上的研究发现与 AIS 患者单独血管内治疗相比,NBO 联合血管内治疗似乎是一种安全可行的治疗策略,可显著减少梗死体积,改善短期神经行为测试评分,90天改善临床预后。

近日,一项发表在Neurology上的研究探讨了常压高氧(NBO)联合血管内治疗(EVT)治疗急性缺血性脑卒中(AIS)的安全性和有效性。

在这项单中心、概念验证、评估者盲法、随机对照的试点研究中,急性前循环 AIS 伴大血管闭塞且有 EVT 指征的患者被随机分配到单独的 EVT 组或 NBO EVT 组。NBO EVT 组在血管再通术前(10L/min,4h)通过面罩给予100% 氧气,而 EVT 组给予室内空气。主要终点是随机分组后24-48小时内 MRI 测量的梗死体积。

  • 共筛选出231例患者,86例患者随机分为1:1(EVT 组,43例; NBO EVT 组,43例)。
  • 随机分组后24-48小时 NBO EVT 组的中位梗死体积显着小于 EVT 组(中位数20.1比37.7 ml,p < 0.01)。
  • NBO EVT 组90天的中位 mRS 评分为2,而 EVT 组为3[调整值1.8,95% CI 1.3-4.2; p = 0.038]。
  • 与 EVT 组相比,NBO ET 组的症状性颅内出血(7% 比12%) ,死亡率(9% 比16%)和不良事件(33% 比42%)的发生率较低; 然而,这种差异无统计学意义。

与 AIS 患者单独血管内治疗相比,NBO 联合血管内治疗似乎是一种安全可行的治疗策略,可以显着减少梗死体积,改善短期神经行为测试评分,并在90天时提高临床结果。这些观察结果需要通过大型多中心随机临床试验进一步证实。

这项初步研究提供了 I 类证据,即常压高氧联合标准血管内治疗可减少急性前循环卒中患者的梗死体积。

文献来源:Li W, Qi Z, Ma Q, et al. Normobaric Hyperoxia Combined With Endovascular Treatment for Acute Ischemic Stroke Patients: A Randomized Controlled Clinical Trial [published online ahead of print, 2022 Jun 17]. Neurology. 2022;10.1212/WNL.0000000000200775. doi:10.1212/WNL.0000000000200775

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    2022-08-05 ms5000000518166734

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    2022-12-26 yinhl1978

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