Lancet:蝶腭神经节刺激有助于改善皮质受累的急性缺血性卒中患者预后

2019-05-27 MedSci MedSci原创

研究认为,影像学证据显示有皮质受累的急性缺血性卒中患者在发作后8-24小时接受蝶腭神经节刺激有助于改善功能结果

在急性缺血性脑卒中临床模型中,蝶腭神经节刺激可增加脑侧支血流量,稳定血脑屏障,缩小梗死范围。近日研究人员开展临床研究考察急性缺血性脑卒中后8-24小时蝶腭神经节刺激对预后的影响。

未接受再灌注治疗的前循环急性缺血性卒中患者(男性40-80岁,女性40-85岁)参与研究,在中风发作后8-24小时接受蝶腭神经节刺激(干预组)或假刺激(对照组)。主要疗效终点是3个月在改良治疗意向(mITT)人群(定义为所有接受过一次积极治疗或假治疗的患者)和经确认的皮质受累(CCI)人群中,残疾恢复水平高于预期的患者比例。安全性终点为严重不良事件(SAEs)、植入物放置或移除相关的SAEs、刺激相关的SAEs、神经恶化和死亡率。

1000例患者至少接受一次蝶腭神经节刺激或对照,481例接受蝶腭神经节刺激,519例为对照,其中520例(52%)接受CCI成像。干预组3个月残疾水平好于预期的患者比例为49%(234/481),对照组为45%(236/519,OR=1.14)。在CCI人群中,干预组为50%(121/244),对照组为40%(110/276,OR=1.48)。在CCI人群中,蝶腭神经节刺激强度与预后呈倒U型相关:在中、低强度时,获得良好结局的比例从40%上升到70%,高强度刺激时下降到40%。组间患者死亡率和SAES差异不显著。

研究认为,影像学证据显示有皮质受累的急性缺血性卒中患者在发作后8-24小时接受蝶腭神经节刺激有助于改善功能结果。

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    2019-11-30 hb2008ye
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    2019-05-27 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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