高压氧联合丹红注射液对缺血性脑卒中患者90天功能独立及1年复发率的影响：一项匹配队列研究

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-05-07 DOI:10.1016/j.jstrokecerebrovasdis.2025.108339

Mo Zheng , Yun Xu

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引用次数: 0

摘要

背景：高压氧治疗和丹参注射液对缺血性脑卒中均显示出潜在的治疗效果，但两者联合使用对长期功能结局和复发风险的影响尚未得到系统评价。本研究旨在探讨高压氧联合丹红注射液对缺血性脑卒中患者90天功能独立性及1年复发率的影响。方法：本研究采用回顾性匹配队列设计，收集2018年1月至2022年12月在我院治疗的缺血性脑卒中患者的数据。经1:1倾向评分匹配，每组80例。干预组在标准治疗的基础上给予高压氧治疗（2.0 ~ 2.5 ATA，每日1次，连用10次），联合丹红注射液（20 ml/天，连用14天）；对照组仅给予标准治疗。主要终点为90天功能独立性（mRS≤2）；次要结局包括1年卒中复发率、NIHSS评分改善等。结果：干预组90天功能独立率（72.5%）显著高于对照组（53.8%）（P=0.014），相对风险比为1.35 （95% CI: 1.06 ~ 1.71）。多因素分析显示，联合治疗与90天功能独立性独立相关(调整OR=2.28, 95% CI: 1.19-4.37；P = 0.013)。干预组1年卒中复发率（7.6%）显著低于对照组（16.5%）（P=0.042），校正风险比为0.46 （95% CI: 0.22 ~ 0.94， P=0.033）。结论：高压氧联合丹红注射液可显著提高缺血性脑卒中患者90天功能独立性，降低1年复发风险，在特定患者亚组中效果显著。这种综合治疗策略为卒中综合管理提供了一种新的治疗选择。

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Effects of hyperbaric oxygen combined with Danhong injection on 90-day functional independence and the 1-year recurrence rate in patients with ischemic stroke: A matched cohort study

Background

Both hyperbaric oxygen therapy and Danshen (Salvia miltiorrhiza) injection have shown potential therapeutic effects on ischemic stroke, but the impact of their combination on long-term functional outcomes and recurrence risk has not been systematically evaluated. This study aimed to assess the effects of hyperbaric oxygen combined with Danhong injection on 90-day functional independence and the 1-year recurrence rate in patients with ischaemic stroke.

Methods

This study employed a retrospective matched cohort design and collected data from patients with ischemic stroke treated at our hospital between January 2018 and December 2022. After 1:1 propensity score matching, 80 patients were included in each group. The intervention group received hyperbaric oxygen therapy (2.0–2.5 ATA, once daily for 10 sessions) combined with Danhong injection (20 ml/day for 14 consecutive days) in addition to standard treatment; the control group received standard treatment only. The primary outcome was 90-day functional independence (mRS ≤2); secondary outcomes included the 1-year stroke recurrence rate, NIHSS score improvement, and others.

Results

The percentage of 90-day functional independence in the intervention group (72.5 %) was significantly greater than that in the control group (53.8 %) (P = 0.014), with a relative risk ratio of 1.35 (95 % CI: 1.06–1.71). Multivariate analysis revealed that combined therapy was independently associated with 90-day functional independence (adjusted OR = 2.28, 95 % CI: 1.19–4.37; P = 0.013). The 1-year stroke recurrence rate in the intervention group (7.6 %) was significantly lower than that in the control group (16.5 %) (P = 0.042), with an adjusted hazard ratio of 0.46 (95 % CI: 0.22–0.94, P = 0.033). Subgroup analysis revealed that patients aged <65 years, those with NIHSS scores ranging from 4–15, those with small-artery occlusion or large-artery atherosclerosis stroke, and those who began treatment within 24 hours benefited more significantly. The combined therapy was well tolerated, with no serious adverse events.

Conclusion

Hyperbaric oxygen combined with Danhong injection significantly improved 90-day functional independence and reduced the 1-year recurrence risk in patients with ischaemic stroke, particularly in specific patient subgroups. This combined treatment strategy provides a new therapeutic option for comprehensive stroke management.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.