缺血性脑卒中患者的院前降压治疗：随机对照试验的系统回顾和元分析》。

IF 6.3 2区医学 Q1 CLINICAL NEUROLOGY

International Journal of Stroke Pub Date : 2024-10-26 DOI:10.1177/17474930241298445

Xiang Yuan, Q I Gan, Yu Zhang, Peng Wang, Weelic Chong, Yang Hai, Fang Fang

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引用次数: 0

摘要

背景：院前血压控制能否改善急性缺血性卒中患者的预后尚不确定。本系统综述和荟萃分析旨在评估缺血性中风患者院前降压治疗的效果：我们检索了 PubMed、Embase 和 Cochrane Central Register of Controlled Trials 中对院前降压治疗与常规治疗或不治疗中风患者进行比较的随机对照试验。主要结果是 90 天后的功能预后，以修改后的 Rankin 量表（mRS）的分布情况进行评估，次要结果是 90 天后的死亡率：结果：在审查的 428 项研究中，有 3 项适合进行分析，共涉及 3878 名患者。在缺血性脑卒中患者中，与常规治疗相比，院前降压治疗与 90 天后较高的 mRS 评分相关（mRS 较差的常见 OR OR 1.27，95% CI 1.08-1.49），并增加了 90 天后的死亡风险（OR 1.28，95% CI 1.02-1.61）：结论：对于缺血性脑卒中患者，院前降压治疗与较高的功能预后不良可能性和较高的死亡风险相关。

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Prehospital Blood Pressure Lowering in Patients with Ischemic Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Background: Whether prehospital blood pressure control improves outcomes among patients with acute ischemic stroke is uncertain. This systematic review and meta-analysis aimed to evaluate the effect of prehospital blood pressure reduction treatment in patients with ischemic stroke.

Methods: We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials that compared prehospital blood pressure reduction treatment with usual treatment or no treatment in patients with stroke. The primary outcome was functional outcome, assessed with the distribution of modified Rankin Scale (mRS) at 90 days, while secondary outcome was mortality at 90 days.

Results: Of 428 studies reviewed, three were appropriate for analysis, totaling 3878 patients. In patients with ischemic stroke, prehospital blood pressure reduction treatment was associated with higher mRS scores at 90 days (common OR for worse mRS OR 1.27, 95% CI 1.08-1.49) and increased risk of mortality at 90 days (OR 1.28, 95% CI 1.02-1.61) compared with the usual treatment.

Conclusion: In patients with ischemic stroke, prehospital blood pressure reduction treatment was associated with a higher likelihood of poor functional outcome and an elevated risk of mortality.

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来源期刊

International Journal of Stroke 医学-外周血管病

CiteScore

13.90

自引率

6.00%

发文量

132

审稿时长

6-12 weeks

期刊介绍： The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.