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Stroke:双重抗血小板治疗可改善渐进性腔隙性卒中患者的功能结局

2019-03-07 xing.T 网络

由此可见,这些结果证实DAPT对进行性腔隙性卒中患者具有潜在的益处。

在20%至30%的腔隙性卒中患者中,早期神经功能恶化(END)发生在卒中发病后的第一天内。然而,这些患者仍然缺乏有效的治疗策略。近日,血管疾病领域权威杂志Stroke上发表了一篇研究文章,该研究的目的是分析双重抗血小板治疗(DAPT)对END患者的疗效。

研究人员对485例腔隙性卒中患者及相应的腔隙性缺血的神经影像学证据进行回顾性筛查END,其通过国家卫生研究院卒中量表总分≥3来定义;筛查麻痹国家卫生研究院卒中量表评分≥2,或在入院后5天内记录到的临床恶化。根据内部标准,END患者采用DAPT治疗。如果出院时美国国立卫生研究院卒中量表评分至少提高到入院时的分数,则可满足主要疗效终点。次要终点是Rankin量表评分,进一步的临床波动和症状性出血并发症。

在458例腔隙性卒中患者中的130例(28%)患者发生了END。这些患者中的97例(75%)在END后使用了DAPT治疗,大多数为5天。DAPT与改善的功能结局相关。DAPT患者中68%(66)符合主要终点,而标准治疗患者为36%(12)(P=0.0019)。79%(77)的DAPT患者缺乏进一步的临床波动,而没有DAPT的患者为33%(11)(P<0.001)。在任何患者中均未观察到症状性出血并发症。

由此可见,这些结果证实DAPT对进行性腔隙性卒中患者具有潜在的益处。

原始出处:


Anne Berberich.et al.Dual Antiplatelet Therapy Improves Functional Outcome in Patients With Progressive Lacunar Strokes.Stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.023789

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    2019-03-08 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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