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PLoS One:A2DS2分数可预测中国缺血性卒中患者卒中相关肺炎和住院死亡

2016-03-14 MedSci MedSci原创

背景和目的:卒中相关性肺炎(SAP)是常见的并发症,并且也是住院期间死亡的重要原因之一。A2DS2(年龄、心房纤颤、吞咽困难、性别、卒中的严重程度)评分是柏林卒中注册开发,能够很好的预测SAP的发生。研究者旨在识别A2DS2评分和SAP之间的关联,并且确定A2DS2评分是否能预测中国人群急性缺血性卒中的死亡。方法:研究者进行了一项回顾性的研究。将1239名急性缺血性脑卒中患者分为低A2DS2组(0

背景和目的:卒中相关性肺炎(SAP)是常见的并发症,并且也是住院期间死亡的重要原因之一。A2DS2(年龄、心房纤颤、吞咽困难、性别、卒中的严重程度)评分是柏林卒中注册开发,能够很好的预测SAP的发生。研究者旨在识别A2DS2评分和SAP之间的关联,并且确定A2DS2评分是否能预测中国人群急性缺血性卒中的死亡。


方法:研究者进行了一项回顾性的研究。将1239名急性缺血性脑卒中患者分为低A2DS2组(0-4)和高A2DS2评分(5-10)组。主要预后为住院卒中相关肺炎的发生,应用Logistic回归分析确定A2DS2评分和SAP之间的关联,以及A2DS2评分和住院死亡的相关性。

结果:急性缺血性卒中后,SAP和住院死亡率的总体发生率分别为7.3%和2.4%的。低SAP组和高A2DS2评分组卒中相关性肺炎的发生率分别为3.3%和24.7%(P<0.001)。在住院期间,1.2%低评分组的患者和7.8%高分组的患者死亡。多元回归分析显示,高评分组患者卒中相关肺炎(OR 8.888, 95%CI:5.552-14.229)和死亡(OR 7.833,95% CI:3.580-17.137)的发生风险高于低评分组的患者。

结论:A2DS2评分是中国急性缺血性患者,卒中相关性肺炎和住院死亡的强预测因子。A2DS2评分可能是预测住院期间发生SAP和死亡的有效评分。


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背景:脑卒中后的不良事件相关的因素并没有完全理解。本研究的目的是调查先前存在压疮的患者,卒中后不良事件是否增加。方法:利用台湾国家健康保险研究数据库的数据,研究者通过倾向得分匹配,进行一项回顾性队列研究。调查的2002和2009间,302名存在压疮的首发卒中患者和与3002名无压疮的卒中患者。应用多因素Logistic回归分析计算:先前存在压疮患者,卒中后,并发症和30天死亡率的校正OR值和95%

PLoS One:涉及岛叶皮质的缺血性卒中,可能是心源性栓塞的危险因素

目的:评估心源性脑栓塞是否与岛叶部位缺血性脑卒中相关。方法:识别症状开始7天内的住院的缺血性卒中患者。基于弥散加权成像,研究包括大脑中动脉(MCA)中缺血性病变。根据梗死是否涉及岛叶,将患者分为两组中一组。主要预后为根据是否涉及岛叶,比较心源性脑栓塞的频率。共有MCAO供血区发生缺血性卒中的患者,112名(8.5%)涉及到岛叶。与未涉及岛叶(30.4%)的患者相比,涉及岛叶卒中(52.7%)的患者

Stroke:急性使用可卡因增加了早发性缺血性脑卒中的风险

虽然病例报告早就确定了使用可卡因和缺血性脑卒中(IS)之间的关联,但很少有流行病学研究阐述青壮年IS与使用可卡因的关联,通过定期的,途径和使用频率进行确定。研究人员进行了一项基于人群的病例对照研究,通过1090例患者和1154名对照来调查使用可卡因和青年人IS发病的关联。卒中病例均在15至49岁之间。采用Logistic回归分析,以评估使用可卡因和IS之间的关联,其中的IS是经过了有或没有潜在的混

NEJM:吡格列酮治疗缺血性卒中或短暂性脑缺血发作效果一般

尽管使用当前的预防性疗法,缺血性中风或短暂性脑缺血发作(TIA)患者的未来心血管事件的风险增加。胰岛素抗性的识别作为中风和心肌梗塞的危险因素,提高了吡格列酮治疗的可能性,改善了胰岛素的敏感性,可能增加脑血管疾病的患者受益的可能性。在这个多中心,双盲试验中,研究人员随机分配3876例近期患缺血性卒中或TIA的患者分别接受吡格列酮(目标剂量,每天45毫克)或安慰剂。符合条件的患者没有糖尿病,但被发现在

Stroke:DASH饮食可降低缺血性卒中风险

坚持饮食疗法停止高血压(DASH)饮食可降低高血压的风险,高血压是脑卒中的主要危险因素。研究人员探讨了是否坚持DASH饮食可降低卒中的发病率。研究人群包括74404名男性和女性(45-83岁),基线时无卒中,这些参与者来自瑞典男性的队列和瑞典乳房X光摄影队列。饮食通过饮食频率问卷评估。一种改进的DASH饮食评分是基于对蔬菜,水果,豆类和坚果,全谷类,低脂奶制品,红肉和加工肉类和含糖饮料消费的产生的

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