Stroke:血压水平是否影响动脉内治疗的安全性?

2017-04-25 MedSci MedSci原创

高血压(BP)与不良结局和急性缺血性脑卒中并发颅内出血有关。但是,BP是否影响动脉内治疗(IAT)的安全性及益处尚不清楚。近期,一项发表在杂志Stroke上的研究旨在评估BP与功能结局、颅内出血症状和IAT的作用之间的关系。此项研究是MR CLEAN(荷兰急性缺血性卒中血管内治疗多中心随机临床试验)的析因分析。在基线、IAT或中风入院之前测量血压。估计基线BP与90天改良Rankin量表评分的关系

高血压(BP)与不良结局和急性缺血性脑卒中并发颅内出血有关。但是,BP是否影响动脉内治疗(IAT)的安全性及益处尚不清楚。


近期,一项发表在杂志Stroke上的研究旨在评估BP与功能结局、颅内出血症状和IAT的作用之间的关系。

此项研究是MR CLEAN(荷兰急性缺血性卒中血管内治疗多中心随机临床试验)的析因分析。在基线、IAT或中风入院之前测量血压。估计基线BP与90天改良Rankin量表评分的关系,以及顺序和逻辑回归分析的安全参数。使用乘法相互作用项测试BP对IAT作用的影响。

此项研究结果显示:收缩压(SBP)与功能结局有最佳的相关性。这种相关性为U形;低基线和高基线SBP与功能不良结果相关。更高的SBP与颅内出血症状相关(调整的优势比,每10mm Hg高的SBP[95%置信区间,1.09-1.44]为1.25)。在SBP和IAT之间,功能结果、颅内出血症状或其他安全性参数之间没有相互作用;对于整个SBP范围,IAT的绝对优势是显而易见的。对舒张压的研究也有同样的发现。

此项研究表明:在由近端颅内血管阻塞引起的急性缺血性卒中患者中,BP不会影响IAT的益处或安全性。不应该因为BP而拒绝或延迟IAT。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1984260, encodeId=1196198426007, content=<a href='/topic/show?id=4af8889533b' target=_blank style='color:#2F92EE;'>#血压水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88953, encryptionId=4af8889533b, topicName=血压水平)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9df476, createdName=fyxzlh, createdTime=Tue Feb 06 01:14:00 CST 2018, time=2018-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=194894, encodeId=3a80194894a3, content=文章很好,值得读, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun May 07 08:17:03 CST 2017, time=2017-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192119, encodeId=8f6e192119bb, content=文章不错,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Apr 30 10:32:03 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190517, encodeId=e46d19051e51, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Tue Apr 25 18:36:30 CST 2017, time=2017-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190506, encodeId=515d19050665, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue Apr 25 16:55:35 CST 2017, time=2017-04-25, status=1, ipAttribution=)]
    2017-05-07 1e10c84am36(暂无匿称)

    文章很好,值得读

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1984260, encodeId=1196198426007, content=<a href='/topic/show?id=4af8889533b' target=_blank style='color:#2F92EE;'>#血压水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88953, encryptionId=4af8889533b, topicName=血压水平)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9df476, createdName=fyxzlh, createdTime=Tue Feb 06 01:14:00 CST 2018, time=2018-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=194894, encodeId=3a80194894a3, content=文章很好,值得读, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun May 07 08:17:03 CST 2017, time=2017-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192119, encodeId=8f6e192119bb, content=文章不错,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Apr 30 10:32:03 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190517, encodeId=e46d19051e51, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Tue Apr 25 18:36:30 CST 2017, time=2017-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190506, encodeId=515d19050665, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue Apr 25 16:55:35 CST 2017, time=2017-04-25, status=1, ipAttribution=)]
    2017-04-30 1e10c84am36(暂无匿称)

    文章不错,值得分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1984260, encodeId=1196198426007, content=<a href='/topic/show?id=4af8889533b' target=_blank style='color:#2F92EE;'>#血压水平#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88953, encryptionId=4af8889533b, topicName=血压水平)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9df476, createdName=fyxzlh, createdTime=Tue Feb 06 01:14:00 CST 2018, time=2018-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=194894, encodeId=3a80194894a3, content=文章很好,值得读, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun May 07 08:17:03 CST 2017, time=2017-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192119, encodeId=8f6e192119bb, content=文章不错,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Apr 30 10:32:03 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190517, encodeId=e46d19051e51, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Tue Apr 25 18:36:30 CST 2017, time=2017-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190506, encodeId=515d19050665, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue Apr 25 16:55:35 CST 2017, time=2017-04-25, status=1, ipAttribution=)]
    2017-04-25 dhzzm

    学习了分享了

    0

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    2017-04-25 三生有幸9135

    学习一下

    0

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由此可见,较低的透析前SBP与透析开始前期高死亡率有关。透析前DBP与透析后的死亡率无关。需要进一步的研究来阐明透析患者理想的透析前SBP水平,以作为改善早期透析死亡率过高的一种手段。