Stroke:缺血性卒中患者心力衰竭的影响

2019-09-28 xing.T MedSci原创

由此可见,在这个现实的卒中患者队列中,HF是功能性长期预后不良的独立预测因子,而患者静脉溶栓和机械再通的安全性和有效性似乎未受到影响。

急性缺血性卒中患者的心力衰竭(HF)是各种有害病理生理机制的源头,包括促血栓形成和促炎状态,脑组织氧合恶化和血液动力学受损。此外,HF可能会影响急性再通性卒中治疗的安全性和有效性。

该前瞻性登记中心纳入了在静脉性重组组织型纤溶酶原激活剂或单发性卒中中心进行机械再通治疗的患者。患者在急性护理期间接受了心脏评估,包括超声心动图检查。90天后通过结构化电话访谈评估功能结局。在倾向评分匹配后,调查了HF患者的静脉溶栓和机械血栓切除术的安全性和有效性,并与正常心功能的患者进行了比较。

该研究招募了129例患者,378名患者(31%)伴有HF,并且是功能预后不良的独立预测因子。静脉溶栓后,机械再通或联合治疗后,HF患者的再通率相当。继发性颅内出血的发生率无差异(7% vs. 8%;溶栓后P=0.909,机械再通或联合治疗后P=0.364,15% vs. 20%)。入院后48小时内的早期死亡率相当(两组均低于1.5%)。

由此可见,在这个现实的卒中患者队列中,HF是功能性长期预后不良的独立预测因子,而患者静脉溶栓和机械再通的安全性和有效性似乎未受到影响。 

原始出处:

Gabriela Siedler.et al.Heart Failure in Ischemic Stroke Relevance for Acute Care and Outcome.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.026139

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    2019-09-28 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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